Nieder Carsten, Dalhaug Astrid, Haukland Ellinor, Mannsaker Bard, Pawinski Adam
Department of Oncology and Palliative Medicine, Nordland Hospital, 8092 Bodo, Norway; Department of Clinical Medicine, Faculty of Health Sciences, University of Tromso, 9037 Tromso, Norway.
Department of Oncology and Palliative Medicine, Nordland Hospital, 8092 Bodo, Norway.
J Clin Med Res. 2017 Mar;9(3):183-187. doi: 10.14740/jocmr2653w. Epub 2017 Jan 25.
The aim of the study was to explore the prognostic impact of different abnormal blood tests and the tumor marker CA 15-3 as well as established parameters such as disease extent and receptor status in patients with bone metastases from breast cancer who received palliative radiotherapy in addition to contemporary systemic treatment.
This was a retrospective uni- and multivariate analysis of 118 female patients treated in the time period from 2007 to 2014 (median follow-up 28 months).
The median age was 61 years and the median time interval from the initial diagnosis of breast cancer was 57 months (median time interval from metastatic disease to radiotherapy was 7 months). Only 16% of patients had normal serum CA 15-3. HER2 receptor status correlated with CA 15-3. The median survival was 17.6 months (lowest CA 15-3 quartile), 14.7 months (intermediate), and 6.9 months (highest quartile) (P = 0.002). However, multivariate analysis showed that survival was influenced by extent of extra-skeletal metastases, pleural metastases/effusion, lung metastases, estrogen receptor status, serum C-reactive protein, and anemia with need for blood transfusion (all P < 0.05) rather than CA 15-3.
Survival was highly variable. The tumor marker CA 15-3 did not provide independent prognostic information. Nevertheless, the results of simple blood tests contributed to the multivariate prognostic model.
本研究旨在探讨不同血液检查异常、肿瘤标志物CA 15-3以及疾病范围和受体状态等既定参数对接受姑息性放疗及当代全身治疗的乳腺癌骨转移患者预后的影响。
这是一项对2007年至2014年期间接受治疗的118例女性患者进行的回顾性单因素和多因素分析（中位随访时间28个月）。
中位年龄为61岁，从乳腺癌初诊开始的中位时间间隔为57个月（从转移性疾病到放疗的中位时间间隔为7个月）。仅16%的患者血清CA 15-3正常。HER2受体状态与CA 15-3相关。中位生存期分别为17.6个月（CA 15-3最低四分位数）、14.7个月（中间四分位数）和6.9个月（最高四分位数）（P = 0.002）。然而，多因素分析显示，生存期受骨外转移范围、胸膜转移/胸腔积液、肺转移、雌激素受体状态、血清C反应蛋白和需要输血的贫血影响（均P < 0.05），而非CA 15-3。
生存期差异很大。肿瘤标志物CA 15-3未提供独立的预后信息。尽管如此，简单血液检查结果有助于多因素预后模型的建立。
