Xing Peng, Dong Huiting, Liu Qun, Yao Fan, Xu Yingying, Chen Bo, Zheng Xinyu, Wu Yunfei, Jin Feng, Li Jiguang
Breast Division, The First Hospital of China Medical University, Shenyang 110001, Liaoning, People's Republic of China.
Oncotarget. 2017 Jun 12;8(60):102499-102510. doi: 10.18632/oncotarget.18454. eCollection 2017 Nov 24.
The purpose of this prospective study is to investigate the impact of endocrine treatment persistence on the survival of patients with estrogen receptor-positive breast cancer treated with endocrine therapy and identify the risk factors influencing the treatment persistence. We enrolled 1085 patients from Northeast China who were diagnosed as stage I-III, estrogen receptor-positive breast cancer between January 2007 and December 2010. The prognostic factors for disease-free survival (DFS) and overall survival (OS) of patients were identified using univariate and multivariate Cox proportional hazards regression models. Multiple logistic regression analysis was done to determine the possible risk factors for non-endocrine treatment and treatment discontinuation. Among the patients enrolled, 598 (55.1%) underwent 5 years of endocrine therapy, 278 (25.6%) less than 5 years, and 209 (19.3%) non-endocrine therapy. OS rates in the continuation, discontinuation, and non-endocrine treatment groups were 97.8%, 92.6% and 74.3%, and DFS 97.5%, 86.2% and 69.9%, respectively. After adjusting for pathological and socioeconomic factors, non-endocrine therapy and discontinuation were independent predictors for DFS and OS. Elderly patients (≥ 65 years), those living in suburban and rural areas, locally advanced patients, and receiving no radiotherapy and/or chemotherapy were more likely to receive non-endocrine therapy and discontinue endocrine treatment. In conclusion, the prospective study demonstrate that the persistence of endocrine treatment is low in estrogen receptor-positive breast cancer patients in Northeast China. Non-endocrine treatment and early discontinuation serve as independent prognostic factors for both DFS and OS of breast cancer patients treated with endocrine therapy.
这项前瞻性研究的目的是调查内分泌治疗持续性对接受内分泌治疗的雌激素受体阳性乳腺癌患者生存的影响，并确定影响治疗持续性的危险因素。我们纳入了1085例来自中国东北的患者，他们在2007年1月至2010年12月期间被诊断为I-III期雌激素受体阳性乳腺癌。使用单因素和多因素Cox比例风险回归模型确定患者无病生存（DFS）和总生存（OS）的预后因素。进行多因素逻辑回归分析以确定非内分泌治疗和治疗中断的可能危险因素。在纳入的患者中，598例（55.1%）接受了5年内分泌治疗，278例（25.6%）少于5年，209例（19.3%）接受非内分泌治疗。继续治疗组、中断治疗组和非内分泌治疗组的OS率分别为97.8%、92.6%和74.3%，DFS率分别为97.5%、86.2%和69.9%。在调整病理和社会经济因素后，非内分泌治疗和治疗中断是DFS和OS的独立预测因素。老年患者（≥65岁）、居住在郊区和农村地区的患者、局部晚期患者以及未接受放疗和/或化疗的患者更有可能接受非内分泌治疗并中断内分泌治疗。总之，这项前瞻性研究表明，中国东北地区雌激素受体阳性乳腺癌患者内分泌治疗的持续性较低。非内分泌治疗和早期中断是接受内分泌治疗的乳腺癌患者DFS和OS的独立预后因素。
