Yanae Masashi, Fujimoto Shinichiro, Tane Kaori, Tanioka Maki, Fujiwara Kimiko, Tsubaki Masanobu, Yamazoe Yuzuru, Morishima Yoshiyuki, Chiba Yasutaka, Takao Shintaro, Komoike Yoshifumi, Tsurutani Junji, Nakagawa Kazuhiko, Nishida Shozo
Department of Pharmacy, Kindai University Hospital, 377-2 Ohno-higashi, Osaka-Sayama, Osaka, Japan.
Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, 3-4-1 Kowakae, Higashi-Osaka, Osaka, Japan.
J Bone Oncol. 2017 Aug 31;8:18-22. doi: 10.1016/j.jbo.2017.08.004. eCollection 2017 Sep.
Bone represents one of the most common sites to which breast cancer cells metastasize. Patients experience skeletal related adverse events (pathological fractures, spinal cord compressions, and irradiation for deteriorated pain on bone) even during treatment with zoledronic acid (ZA). Therefore, we conducted a retrospective cohort study to investigate the predictive factors for symptomatic skeletal events (SSEs) in bone-metastasized breast cancer (b-MBC) patients.
We retrospectively collected data on b-MBC patients treated with ZA. Patient characteristics, including age, subtype, the presence of non-bone lesions, the presence of multiple bone metastases at the commencement of ZA therapy, duration of ZA therapy, the time interval between breast cancer diagnosis and the initiation of ZA therapy, and type of systemic therapy, presence of previous SSE were analyzed using multivariable logistic regression analysis.
The medical records of 183 patients were reviewed and 176 eligible patients were analyzed. The median age was 59 (range, 30-87) years. Eighty-seven patients were aged ≥60 years and 89 patients were aged < 60 years. The proportions of patients with estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2-positive disease were 81.8%, 63.1%, and 17.6%, respectively. Fifty-three patients had bone-only MBC at the commencement of ZA therapy. SSEs were observed in 42 patients. In the multivariable logistic regression analysis, bone-only MBC but not a breast cancer subtype was an independent risk factor for an SSE during ZA therapy (odds ratio: 3.878, 95% confidence interval: 1.647-9.481; p = 0.002).
Bone-only MBC patients are more likely to experience an SSE even after treatment with ZA.
骨骼是乳腺癌细胞最常见的转移部位之一。即使在接受唑来膦酸（ZA）治疗期间，患者仍会经历骨骼相关不良事件（病理性骨折、脊髓压迫以及因骨痛恶化而进行的放疗）。因此，我们开展了一项回顾性队列研究，以调查骨转移乳腺癌（b-MBC）患者发生有症状骨骼事件（SSEs）的预测因素。
我们回顾性收集了接受ZA治疗的b-MBC患者的数据。使用多变量逻辑回归分析对患者特征进行分析，包括年龄、亚型、非骨病变的存在情况、ZA治疗开始时多发骨转移的存在情况、ZA治疗持续时间、乳腺癌诊断与ZA治疗开始之间的时间间隔、全身治疗类型以及既往SSE的存在情况。
对183例患者的病历进行了审查，分析了176例符合条件的患者。中位年龄为59岁（范围30 - 87岁）。87例患者年龄≥60岁，89例患者年龄<60岁。雌激素受体、孕激素受体和人表皮生长因子受体2阳性疾病患者的比例分别为81.8%、63.1%和17.6%。53例患者在ZA治疗开始时仅有骨转移的MBC。42例患者观察到SSEs。在多变量逻辑回归分析中，仅有骨转移的MBC而非乳腺癌亚型是ZA治疗期间发生SSE的独立危险因素（比值比：3.878，95%置信区间：1.647 - 9.481；p = 0.002）。
即使接受ZA治疗后，仅有骨转移的MBC患者发生SSE的可能性更高。
