Patil Roshankumar, Pandit Prakash, Palwe Vijay, Kate Shruti, Gandhe Sucheta, Patil Rahul, Ramesh Yasam Venkata, Nagarkar Raj
Department of Radiation Oncology, HCG Manavata Cancer Centre, Maharashtra, India.
Department of Medical Oncology, HCG Manavata Cancer Centre, Maharashtra, India.
Eur J Breast Health. 2020 Dec 24;17(1):62-67. doi: 10.4274/ejbh.2020.5969. eCollection 2021 Jan.
This study aimed to evaluate various prognostic factors that play a vital role in stratifying and guiding tailored treatment strategies and survival outcome in breast cancer patients with brain metastases (BM).
Data regarding demography, clinical presentation, molecular subtypes, risk-stratification, treatment details, and outcomes were retrieved from medical records. All time-to-event (survival) outcomes were analyzed by Kaplan-Meir method and compared using log-rank test. Univariate and multivariate analysis of relevant prognostic factors were performed and p-values ≤0.05 were considered statistically significant.
A total of 88 patients (median age: 50 years) were included for this study. The median follow-up time of all surviving patients was ~20 months. During the follow-up, 82 (93.1%) patients died. The median survival of all patients was 12 months, with 1-year and 2-year overall survival (OS) rate of 51% and 22%, respectively. Based on univariate analysis, statistically significant prognostic factors for OS were molecular subtypes, number of BM, and Karnofsky Performance Status (KPS); however, number of BM and KPS emerged as independent predictors of survival based on multivariate analysis.
We conclude that, there are other important prognostic factor, such as number of BM, which may affect the OS of these patients, in addition to variables included in the diagnosis-specific graded prognostic assessment score. Prospective studies evaluating these factors are necessary to further refine the stratification of patients, which will aid the initiation of appropriate treatment to improve the OS of patients.
本研究旨在评估各种预后因素，这些因素在对脑转移（BM）乳腺癌患者进行分层和指导个体化治疗策略及生存结局方面起着至关重要的作用。
从病历中检索有关人口统计学、临床表现、分子亚型、风险分层、治疗细节及结局的数据。所有事件发生时间（生存）结局采用Kaplan-Meir法分析，并使用对数秩检验进行比较。对相关预后因素进行单因素和多因素分析，p值≤0.05被认为具有统计学意义。
本研究共纳入88例患者（中位年龄：50岁）。所有存活患者的中位随访时间约为20个月。随访期间，82例（93.1%）患者死亡。所有患者的中位生存期为12个月，1年和2年总生存率（OS）分别为51%和22%。基于单因素分析，OS的统计学显著预后因素为分子亚型、BM数量和卡诺夫斯基体能状态（KPS）；然而，基于多因素分析，BM数量和KPS成为生存的独立预测因素。
我们得出结论，除了诊断特异性分级预后评估评分中包含的变量外，还有其他重要的预后因素，如BM数量，可能会影响这些患者的OS。评估这些因素的前瞻性研究对于进一步完善患者分层是必要的，这将有助于启动适当的治疗以提高患者的OS。
