Division of Interventional Radiology, Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd. NE, Suite D112, Atlanta, GA 30322.
Division of Medical Oncology, Department of Medicine, Emory University School of Medicine, 1364 Clifton Rd. NE, Suite D112, Atlanta, GA 30322.
J Vasc Interv Radiol. 2020 Jun;31(6):925-933. doi: 10.1016/j.jvir.2019.12.013. Epub 2020 Apr 16.
To determine predictors of survival after transarterial radioembolization of hepatic metastases from breast cancer.
Twenty-four patients with chemotherapy-refractory hepatic metastases from breast cancer who underwent radioembolization from 2013 to 2018 were evaluated based on various demographic and clinical factors before and after treatment. Overall survival (OS) was estimated by Kaplan-Meier method. Log-rank analysis was performed to determine predictors of prolonged OS from the time of first radioembolization and first hepatic metastasis diagnosis.
Median OS times were 35.4 and 48.6 months from first radioembolization and time of hepatic metastasis diagnosis, respectively. Radioembolization within 6 months of hepatic metastasis diagnosis was a positive predictor of survival from first radioembolization, with median OS of 38.9 months vs 22.1 months for others (P = .033). Estrogen receptor (ER)-positive status predicted prolonged survival (38.6 months for ER vs 5.4 months for ER; P = .005). The presence of abdominal pain predicted poor median OS: 12.8 months vs 38.6 months for others (P < .001). The presence of ascites was also a negative predictor of OS (1.7 months vs 35.4 months for others; P = .037), as was treatment-related grade ≥ 2 toxicity at 3 months (5.4 months vs 38.6 months for others; P = .017).
In patients with metastatic breast cancer, radioembolization within 6 months of hepatic metastasis diagnosis and ER status appear to be positive predictors of prolonged survival. Conversely, baseline abdominal pain, baseline ascites, and treatment-related grade ≥ 2 toxicity at 3 months after treatment appear to be negative predictors of OS.
确定乳腺癌肝转移经动脉放射性栓塞治疗后生存的预测因素。
回顾性分析 2013 年至 2018 年间 24 例化疗耐药性乳腺癌肝转移患者的各种治疗前后的人口统计学和临床资料。采用 Kaplan-Meier 法估计总生存期（OS）。采用对数秩检验分析从首次放射性栓塞治疗和首次肝转移诊断开始时，延长 OS 的预测因素。
从首次放射性栓塞治疗和肝转移诊断时间起，中位 OS 时间分别为 35.4 个月和 48.6 个月。肝转移诊断后 6 个月内行放射性栓塞治疗是生存的阳性预测因素，中位 OS 为 38.9 个月，而其他时间为 22.1 个月（P=0.033）。雌激素受体（ER）阳性状态预测生存时间延长（ER 为 38.6 个月，ER 为 5.4 个月；P=0.005）。存在腹痛预测中位 OS 较差：12.8 个月对其他情况为 38.6 个月（P<0.001）。腹水的存在也是 OS 的负预测因素（其他情况为 1.7 个月，35.4 个月；P=0.037），3 个月时与治疗相关的 2 级以上毒性也是如此（其他情况为 5.4 个月，38.6 个月；P=0.017）。
在转移性乳腺癌患者中，肝转移诊断后 6 个月内进行放射性栓塞治疗和 ER 状态似乎是延长生存的阳性预测因素。相反，基线时的腹痛、基线时的腹水和治疗后 3 个月与治疗相关的 2 级以上毒性似乎是 OS 的负预测因素。
