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乳癌术后方预防乳腺癌肺转移的临床疗效评价:一项基于倾向评分匹配的回顾性研究

Evaluation of the clinical efficacy of Ru'ai Shuhou recipe for the prevention of lung metastases from breast cancer: a retrospective study based on propensity score matching.

作者信息

Du Nan-Nan, Shao Shi-Jun, Feng Jia-Mei, Wan Hua, Wu Xue-Qing

机构信息

Breast Department, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.

出版信息

Front Pharmacol. 2024 Aug 2;15:1406862. doi: 10.3389/fphar.2024.1406862. eCollection 2024.

Abstract

BACKGROUND

Breast cancer lung metastasis occurs at a high rate and at an early stage, and is the leading cause of death in breast cancer patients. The aim of this study was to investigate the effect of Ru'ai Shuhou Recipe (RSR) intervention on the occurrence of recurrent metastases, especially lung metastases, in postoperative patients with breast cancer.

MATERIALS AND METHODS

A retrospective cohort study was implemented at Shuguang Hospital of Shanghai University of Traditional Chinese Medicine in China between January 2014 to January 2019. Female patients were included according to the propensity score matching (PSM) method and balanced on the basis of general and clinical information such as age, body mass index, neo-adjuvant therapy, and surgical approach. Patients with pathological diagnosis of breast cancer were included in this study. Breast cancer patients were divided into exposed and non-exposed groups according to whether they took RSR-based botanical drugs after surgery. Kaplan-Meier survival analysis and Cox survival analysis to explore the relationship between RSR and 5-year disease-free survival and incidence of lung metastases in breast cancer patients after surgery.

RESULTS

360 female patients were assessed and 190 patients were included in the study after PSM (95 in each of the exposed and non-exposed groups). Of the 190 patients after PSM, 55.79% were over 50 years of age. The mean follow-up time was 60.55 ± 14.82 months in the exposed group and 57.12 ± 16.37 months in the non-exposed group. There was no significant baseline characteristics difference between two groups. Kaplan-Meier analysis showed that the 5-year incidence of lung metastases was significantly lower in the exposed group, and the disease-free survival of patients was significantly longer. Cox univariate and multivariate analysis showed that neoadjuvant chemotherapy and lymph node metastasis were independent risk factors for the development of breast cancer lung metastasis, with risk ratios of 17.188 and 5.812, while RSR treatment was an independent protective factor against the development of breast cancer lung metastasis, with a risk ratio of 0.290.

CONCLUSION

Standard biomedical treatment combined with RSR intervention can better prevent breast cancer recurrence and metastasis, reduce the incidence of lung metastasis in patients, and improve long-term prognosis.

摘要

背景

乳腺癌肺转移发生率高且出现较早,是乳腺癌患者死亡的主要原因。本研究旨在探讨乳癌术后方(RSR)干预对乳腺癌术后患者复发转移尤其是肺转移发生的影响。

材料与方法

2014年1月至2019年1月在中国上海中医药大学附属曙光医院开展一项回顾性队列研究。根据倾向评分匹配(PSM)方法纳入女性患者,并在年龄、体重指数、新辅助治疗及手术方式等一般和临床信息基础上进行平衡。纳入病理诊断为乳腺癌的患者。乳腺癌患者术后根据是否服用以RSR为基础的植物药分为暴露组和非暴露组。采用Kaplan-Meier生存分析和Cox生存分析探讨RSR与乳腺癌患者术后5年无病生存及肺转移发生率之间的关系。

结果

评估360例女性患者,PSM后190例患者纳入研究(暴露组和非暴露组各95例)。PSM后的190例患者中,55.79%年龄超过50岁。暴露组平均随访时间为60.55±14.82个月,非暴露组为57.12±16.37个月。两组间基线特征无显著差异。Kaplan-Meier分析显示,暴露组肺转移5年发生率显著较低,患者无病生存期显著更长。Cox单因素和多因素分析显示,新辅助化疗和淋巴结转移是乳腺癌肺转移发生的独立危险因素,风险比分别为17.188和5.812,而RSR治疗是预防乳腺癌肺转移发生的独立保护因素,风险比为0.290。

结论

标准生物医学治疗联合RSR干预可更好地预防乳腺癌复发转移,降低患者肺转移发生率,改善长期预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a029/11327059/acfd913f8d0f/fphar-15-1406862-g001.jpg

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