Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
Department of Medicine, University of Wisconsin Carbone Cancer Center, 600 Highland Ave, Madison, WI, 53705, USA.
Breast Cancer Res Treat. 2021 Apr;186(3):871-882. doi: 10.1007/s10549-021-06116-8. Epub 2021 Feb 11.
Metastatic phyllodes tumors of the breast (MPT) are rare breast neoplasms, limiting development of standardized treatment approaches. We sought to characterize the largest group of MPT thus far reported, evaluating systemic therapy outcomes.
Adult patients diagnosed with MPT between 1993 and 2015 and followed at MD Anderson Cancer Center were selected for retrospective chart review. Systemic therapy was sorted into: adriamycin/ifosfamide (AI), other anthracycline regimens, other ifosfamide regimens, gemcitabine-based regimens, and other. Given one patient may have received more than one regimen, we assumed that the effects of each regimen were independent from previous therapy. Median overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan-Meier method. Log-rank test was performed to evaluate the difference in OS between patient characteristics groups, and the differences in PFS between the five chemotherapy regimens.
We identified 50 MPT patients, with 31 patients receiving 61 systemic regimens. Median OS was 10.7 months (95% CI: 8.67, 16.5). AI had a PFS of 9.10 months (95% CI: 5.03, 14.2), other ifosfamide regimens had a PFS of 5.10 months (95% CI: 0.67, 12.1), other anthracycline regimens had a PFS of 3.65 months (95% CI: 1.17, 7.90), gemcitabine-based regimens had a PFS of 2.80 months (95% CI: 1.83, 4.60), and other regimens had a PFS of 1.67 months (95% CI: 1.13, 7.77).
MPT patients are a unique population with limited characterization to date. Our study demonstrates activity of multiple sarcoma-directed chemotherapy regimens, with ifosfamide-containing regimens having the longest PFS.
乳腺叶状肿瘤转移（MPT）是一种罕见的乳腺肿瘤，这限制了标准化治疗方法的发展。我们旨在分析迄今为止报道的最大 MPT 患者群体，评估其系统治疗的结果。
选择 1993 年至 2015 年间在 MD 安德森癌症中心诊断为 MPT 并接受随访的成年患者进行回顾性病历审查。系统治疗分为：阿霉素/异环磷酰胺（AI）、其他蒽环类药物方案、其他异环磷酰胺方案、吉西他滨为基础的方案和其他方案。由于每位患者可能接受了不止一种方案，因此我们假设每种方案的效果与之前的治疗无关。采用 Kaplan-Meier 法估计中位总生存期（OS）和无进展生存期（PFS）。采用对数秩检验评估患者特征组间 OS 的差异，以及五种化疗方案间 PFS 的差异。
我们共纳入 50 例 MPT 患者，其中 31 例患者接受了 61 种系统治疗方案。中位 OS 为 10.7 个月（95%CI：8.67，16.5）。AI 的 PFS 为 9.10 个月（95%CI：5.03，14.2），其他异环磷酰胺方案的 PFS 为 5.10 个月（95%CI：0.67，12.1），其他蒽环类药物方案的 PFS 为 3.65 个月（95%CI：1.17，7.90），吉西他滨为基础的方案的 PFS 为 2.80 个月（95%CI：1.83，4.60），其他方案的 PFS 为 1.67 个月（95%CI：1.13，7.77）。
MPT 患者是一个独特的群体，目前对其特征的描述有限。我们的研究表明，多种肉瘤靶向化疗方案具有活性，其中异环磷酰胺方案的 PFS 最长。
