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接受放射治疗的乳腺癌骨转移患者的预后评估。

Prognostic assessment of patients who receive radiotherapy for bone metastases from breast cancer.

作者信息

Makita Kenji, Kanzaki Hiromitsu, Hamamoto Yasushi, Nagasaki Kei, Kataoka Masaaki, Kido Teruhito, Ohsumi Shozo

机构信息

Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791-0280, Japan.

Department of Radiology, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.

出版信息

Oncol Lett. 2023 Mar 28;25(5):188. doi: 10.3892/ol.2023.13775. eCollection 2023 May.

Abstract

For prognostic assessment in women who receive radiotherapy (RT) for bone metastases (BMs) from breast cancer (BC), prognostic factors specific for BMs from BC were investigated in the present study. The prognostic assessment was performed by retrospectively reviewing 143 women who received first-time RT for BMs from BC between January 2007 and June 2018. The median follow-up time and median overall survival (OS) time from the first-time RT for BMs were 22 and 18 months, respectively. In the multivariate analysis, nuclear grade 3 (NG 3) [hazard ratio, 2.18; 95% confidence interval (CI), 1.34-3.53], brain metastases (hazard ratio, 1.96; 95% CI, 1.01-3.81), liver metastases (hazard ratio, 1.75; 95% CI, 1.17-2.63), performance status (PS) (hazard ratio, 1.63; 95% CI, 1.10-2.41) and previous systemic therapy (hazard ratio, 1.58; 95% CI, 1.03-2.42) were significant factors for OS, whereas age, hormone-receptor/human epidermal growth factor receptor 2 status, number of BMs and synchronous lung metastases were not significant factors. When points according to risk levels [unfavorable points (UFPs)] were assigned to each risk factor (1.5 points for NG 3 and brain metastases; and 1 point for PS ≥2, previous systemic therapy and liver metastases), the median OS times of patients with a total number of UFPs ≤1 (n=45), 1.5-3 (n=55) and ≥3.5 (n=43) were 36, 17 and 6 months, respectively. Overall, in patients who received first-time RT for BMs from BC, NG 3, brain/liver metastases, poor PS and previous systemic therapy were unfavorable prognostic factors. Comprehensive prognostic assessment using these factors seemed to be useful for the prediction of prognoses in patients with BMs from BC.

摘要

为了对因乳腺癌(BC)骨转移(BMs)而接受放疗(RT)的女性进行预后评估,本研究调查了BC骨转移特有的预后因素。通过回顾性分析2007年1月至2018年6月期间首次因BC骨转移接受放疗的143名女性进行预后评估。从首次放疗至骨转移的中位随访时间和中位总生存期(OS)分别为22个月和18个月。在多变量分析中,核分级3级(NG 3)[风险比,2.18;95%置信区间(CI),1.34 - 3.53]、脑转移(风险比,1.96;95% CI,1.01 - 3.81)、肝转移(风险比,1.75;95% CI,1.17 - 2.63)、体能状态(PS)(风险比,1.63;95% CI,1.10 - 2.41)和既往全身治疗(风险比,1.58;95% CI,1.03 - 2.42)是OS的显著因素,而年龄、激素受体/人表皮生长因子受体2状态、骨转移数量和同步肺转移不是显著因素。当根据风险水平[不利点数(UFPs)]为每个风险因素赋值时(NG 3和脑转移为1.5分;PS≥2、既往全身治疗和肝转移为1分),UFPs总数≤1(n = 45)、1.5 - 3(n = 55)和≥3.5(n = 43)的患者的中位OS时间分别为36个月、17个月和6个月。总体而言,在因BC骨转移接受首次放疗的患者中,NG 3、脑/肝转移、PS差和既往全身治疗是不良预后因素。使用这些因素进行综合预后评估似乎有助于预测BC骨转移患者的预后。

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