Department of Radiation Oncology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
Department of Internal medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
Breast J. 2018 Nov;24(6):920-926. doi: 10.1111/tbj.13111. Epub 2018 Sep 14.
To evaluate the survival outcomes based on molecular subtypes of breast cancer in patients with brain metastasis.
We retrospectively reviewed 106 breast cancer patients treated for brain metastases, from January 2005 to May 2016. Patients were divided into four groups based on the tumor molecular subtype: luminal A (Estrogen Receptor [ER]/Progesterone Receptor [PR] positive, human epithelial growth factor receptor-2 [HER2] negative), luminal B (ER/PR positive, HER2 Positive), HER2 (HER2 positive and ER/PR negative), and Triple negative (TNBC).
The median follow-up time for surviving patients was 22 months (range: 11.2-51.1 months). The median survival of all patients was 14 months, with a 1-year overall survival (OS) rate of 57.5% and a 2-year OS rate of 32.1%. Thirty patients (28.3%) had a solitary brain metastasis while 62 (58.5%) patients had multiple metastases. A significant difference was observed in the survival rates of the two groups. Based on the Karnofsky performance score, the performance status of the patients at the time of brain metastasis was also found to affect survival. Patients with different molecular subtypes had different survival rates; the luminal A group showed the highest median survival (luminal A: 23.1, luminal B: 15.0, HER2: 12.5 and TNBC: 6.4 months, respectively), which was statistically significant.
In breast cancer patients with brain metastasis, survival rates were different based on the molecular subtype of the tumor, despite various local and systemic treatments. Appropriate and tailored treatment approaches should, therefore, be considered for the different molecular subtypes.
评估乳腺癌脑转移患者基于分子亚型的生存结果。
我们回顾性分析了 2005 年 1 月至 2016 年 5 月间 106 例接受脑转移治疗的乳腺癌患者。根据肿瘤分子亚型，将患者分为 4 组：Luminal A（雌激素受体[ER]/孕激素受体[PR]阳性，人表皮生长因子受体 2[HER2]阴性）、Luminal B（ER/PR 阳性，HER2 阳性）、HER2（HER2 阳性且 ER/PR 阴性）和三阴性乳腺癌（TNBC）。
生存患者的中位随访时间为 22 个月（范围：11.2-51.1 个月）。所有患者的中位生存时间为 14 个月，1 年总生存率（OS）为 57.5%，2 年 OS 率为 32.1%。30 例（28.3%）患者仅有单发脑转移，62 例（58.5%）患者有多发转移。两组患者的生存率存在显著差异。基于 Karnofsky 表现评分，脑转移时患者的表现状态也被发现影响生存。不同分子亚型的患者具有不同的生存率；Luminal A 组的中位生存时间最高（Luminal A：23.1，Luminal B：15.0，HER2：12.5，TNBC：6.4 个月），差异具有统计学意义。
在乳腺癌脑转移患者中，尽管采用了各种局部和全身治疗，生存率仍因肿瘤的分子亚型而异。因此，应考虑针对不同的分子亚型采用适当的个体化治疗方法。
