Yoo Tae-Kyung, Jang Myoung-Jin, Lee Eunshin, Moon Hyeong-Gon, Noh Dong-Young, Han Wonshik
Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea.
J Breast Cancer. 2018 Mar;21(1):37-44. doi: 10.4048/jbc.2018.21.1.37. Epub 2018 Mar 23.
An association between endocrine treatment-related symptoms and breast cancer recurrence has been suggested previously; however, conflicting results have been reported. We performed a meta-analysis of published studies to clarify this relationship.
We systematically searched PubMed, Embase, Scopus, and the Cochrane database for studies investigating the association between endocrine treatment-related symptoms and patient survival. Random-effects meta-analysis was conducted with recurrence rate as the primary outcome.
Out of 7,713 retrieved articles, six studies were included. In patients who received endocrine treatment, the presence of any endocrine treatment-related symptom was found to be associated with a lower recurrence rate in comparison to an absence of any symptoms (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.66-0.87). This relationship persisted in patients presenting with only vasomotor or only musculoskeletal symptoms (HR, 0.74, 95% CI, 0.63-0.87; HR, 0.69, 95% CI, 0.55-0.86, respectively). At both time-points of symptom evaluation (3 months and 12 months), patients with endocrine treatment-related symptoms had a lower recurrence rate (HR, 0.74, 95% CI, 0.66-0.84; HR, 0.79, 95% CI, 0.69-0.90, respectively). This association was also significant in pooled studies including patients with and without baseline symptoms (HR, 0.73, 95% CI, 0.54-0.99; HR, 0.76, 95% CI, 0.69-0.85, respectively).
Endocrine treatment-related symptoms are significantly predictive of lower recurrence rate in breast cancer patients, regardless of the type of symptoms, time-point of evaluation, or inclusion of baseline symptoms. These symptoms could be biomarkers for the prediction of long-term responses to endocrine treatment in patients with breast cancer.
先前已有研究表明内分泌治疗相关症状与乳腺癌复发之间存在关联；然而，报道的结果相互矛盾。我们对已发表的研究进行了荟萃分析，以阐明这种关系。
我们系统检索了PubMed、Embase、Scopus和Cochrane数据库，查找有关内分泌治疗相关症状与患者生存率之间关联的研究。以复发率作为主要结局指标进行随机效应荟萃分析。
在检索到的7713篇文章中，纳入了6项研究。在接受内分泌治疗的患者中，发现存在任何内分泌治疗相关症状与无任何症状相比，复发率较低（风险比[HR]，0.76；95%置信区间[CI]，0.66 - 0.87）。这种关系在仅出现血管舒缩症状或仅出现肌肉骨骼症状的患者中也持续存在（HR分别为0.74，95% CI，0.63 - 0.87；HR为0.69，95% CI，0.55 - 0.86）。在症状评估的两个时间点（3个月和12个月），有内分泌治疗相关症状的患者复发率均较低（HR分别为0.74，95% CI，0.66 - 0.84；HR为0.79，95% CI，0.69 - 0.90）。在纳入有和无基线症状患者的汇总研究中，这种关联也很显著（HR分别为0.73，95% CI，0.54 - 0.99；HR为0.76，95% CI，0.69 - 0.85）。
内分泌治疗相关症状可显著预测乳腺癌患者较低的复发率，无论症状类型、评估时间点或是否纳入基线症状。这些症状可能是预测乳腺癌患者内分泌治疗长期反应的生物标志物。
