谢晓娟, 王忱, 贾勇圣, 刘晓东, 佟仲生. 双膦酸盐治疗乳腺癌骨转移患者的临床病理特征及预后分析*[J]. 中国肿瘤临床, 2015, 42(23): 1132-1137. DOI: 10.3969/j.issn.1000-8179.2015.23.006
引用本文: 谢晓娟, 王忱, 贾勇圣, 刘晓东, 佟仲生. 双膦酸盐治疗乳腺癌骨转移患者的临床病理特征及预后分析*[J]. 中国肿瘤临床, 2015, 42(23): 1132-1137. DOI: 10.3969/j.issn.1000-8179.2015.23.006
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Xiaojuan XIE, Chen WANG, Yongsheng JIA, Xiaodong LIU, Zhongheng TONG. Analysis of clinicopathological features and prognostic factors in bisphosphonate-treated breast cancer patients with bone metastasis[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2015, 42(23): 1132-1137. DOI: 10.3969/j.issn.1000-8179.2015.23.006
Citation: Xiaojuan XIE, Chen WANG, Yongsheng JIA, Xiaodong LIU, Zhongheng TONG. Analysis of clinicopathological features and prognostic factors in bisphosphonate-treated breast cancer patients with bone metastasis[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2015, 42(23): 1132-1137. DOI: 10.3969/j.issn.1000-8179.2015.23.006
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双膦酸盐治疗乳腺癌骨转移患者的临床病理特征及预后分析*

Analysis of clinicopathological features and prognostic factors in bisphosphonate-treated breast cancer patients with bone metastasis

    摘要
  • 摘要: 目的：探讨乳腺癌骨转移患者的临床、病理、治疗及预后因素。方法：收集2005年1 月至2013年4 月天津医科大学肿瘤医院收治的183 例至少接受6 个月双膦酸盐治疗的乳腺癌骨转移患者的临床资料，根据双膦酸盐类型分为帕米膦酸二钠组、唑来膦酸组及帕米膦酸二钠序贯唑来膦酸组，探讨骨转移的特点、骨相关事件（skeletal-related events，SREs）、治疗及预后特征。结果：胸椎和肋骨为骨转移的常见转移部位，骨转移至发生首次SREs的中位时间为4.2 个月，51.9%（95/ 183）患者发生SREs，累计SREs事件数达167 次，其中110 次（65.9%）发生在骨转移后1 年内，SREs类型以骨放疗为主。患者在不同双膦酸盐药物组的SREs发生率差异无统计学意义（P > 0.05）。 183 例患者骨转移后的中位生存期为43.1 个月，激素受体状态、无病生存期、是否合并内脏转移及脊柱转移与否是乳腺癌骨转移患者的独立预后因素（P < 0.05）。 结论：胸椎和肋骨是乳腺癌骨转移的常见转移部位，SREs主要发生在骨转移后1 年内并以骨放疗为主。激素受体阴性、无病生存期短、合并内脏及脊柱转移是影响乳腺癌患者骨转移不良预后的独立因素。

     

    Abstract: Objective:To analyze the clinicopathological characteristics of breast cancer patients with bone metastasis and determine the features of metastasis and treatment, as well as the prognostic factors in these patients. Methods: The clinical and pathological features of 183 bone metastatic advanced breast cancer patients who had received bisphosphonates (BPs) for ≥6 months between January 2005 and April2013 in our hospital were retrospectively analyzed. The features of bone metastasis, skeletal-related events (SREs), and characteristics of treatment and prognostic factors were also studied. On the basis of the BP type, patients were divided into three groups with pamidronate, zoledronate, or pamidronate sequential zoledronate therapies. Results:Thoracic vertebrae and ribs were the most common sites of bone metastases. The median time from bone metastasis to the occurrence of first SRE was 4.2 months. SREs occurred in51 .9% (95 /183) of the patients, in which the accumulative total number of SREs was 167 times. Out of the total 167 times, 110 occurred 1 year after bone metastasis, and bone irradiation ranked first among the therapies for SREs. The incidence rates of SREs after treatments with different BPs were compared, and no statistical difference was found among the three groups ( P>0.05 ). The median overall survival after bone metastases of all the 183 patients was 43 .1 months. In a multivariate analysis, the hormone receptor status, disease-free survival, and visceral and vertebral metastases were the independent predictors for the survival of bone metastatic breast cancer patients (P<0.05 ). Conclusion: Thoracic vertebrae and ribs were the most common sites of bone metastases in breast cancer patients. SREs mainly occurred 1 year after bone metastases, and bone irradiation was the main therapy for SREs. The negative hormone receptor status, short disease-free survival, and visceral and vertebral metastases were independent factors of poor prognosis for the survival of bone metastatic breast cancer patients.

     

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