98例乳腺癌肝转移患者的回顾性研究分析  

Retrospective Analysis of 98 Cases of Breast Cancer with Liver Metastasis

作　　者：朱美琴[1] 张东生[1] 苏争艳[1] 史艳侠[1] 彭柔君[1] 周宁宁[1] 刘冬耕[1] 姜文奇[1] 

机构地区：[1]华南肿瘤学国家重点实验室

出　　处：《癌症》2007年第4期423-426,共4页Chinese Journal of Cancer

摘　　要：背景与目的:乳腺癌肝转移患者预后不良,对化疗敏感性差,化疗缓解期短,生存期短。如何提高乳腺癌肝转移的治疗效果、延长患者的生存期,是目前临床研究中亟需解决的问题。本研究回顾性分析影响乳腺癌肝转移患者预后的因素,并探讨化疗及肝动脉栓塞灌注化疗治疗乳腺癌肝转移的疗效。方法:回顾性分析1996～2005年间98例乳腺癌肝转移的临床资料,采用多因素分析方法(Cox模型)分析乳腺癌肝转移患者的临床特征、治疗方法及与预后的关系,并比较不同治疗方法的疗效。结果:98例乳腺癌肝转移患者,治疗的总有效率为45.9%(45/98),单纯全身化疗组有效率为48.6%(36/74),单纯肝动脉栓塞灌注化疗组为23.1%(3/13),全身化疗加肝动脉栓塞灌注化疗组为54.6%(6/11)。全组中位随访期17个月(3～56个月),中位无疾病进展时间为6个月(0～50个月),中位生存期为17个月(3～56个月)。1、2、3、4年生存率分别为36.0%、19.0%、13.0%和3.0%。结论:采用全身化疗加肝动脉栓塞灌注化疗治疗乳腺癌肝转移疗效较好,值得在仅有肝转移的晚期乳腺癌患者中作进一步研究。多因素分析结果表明,术后至发生肝转移时间少于24个月、姑息化疗疗程数少于6个是预后危险因素。BACKGROUND ＆ OBJECTIVE： The prognosis of breast cancer patients with liver metastasis is poor. How to improve treatment efficacy and prolong survival of these patients is a challenge in clinic. This study was to explore the efficacy of chemotherapy and transcatheter arterial chemoembolization （TACE） on breast cancer patients with liver metastasis, and analyze prognostic factors. METHODS： Clinical data of 98 breast cancer patients with liver metastasis, treated from 1996 to 2005 in Cancer Center of Sun Yat-sen University, were analyzed retrospectively. The prognostic factors correlated to clinical features and treatment approaches were determined using Cox multivariate model. RESULTS： The total response rate was 45.9% for all patients, 48.6% for the 74 patients received systemic chemotherapy, 23.1% for the 13 patients received TACE, and 54.6% for the 11 patients received chemotherapy plus TACE. At a median follow-up of 17 months （3-56 months）, the 1-, 2-, 3-, and 4-year survival rates were 36%, 19%, 13%, and 3%, respectively; the median survival was 17 months （3-56 months）, and the progression-free survival was 6 months （0-50 months）. CONCLUSION： The combination of systemic chemotherapy and TACE may prolong the survival of breast cancer patients with liver metastasis.

关 键 词：乳腺肿瘤 肝肿瘤/继发性 全身化疗 肝动脉栓塞灌注化疗 疗效 预后因素 多因素分析 

分 类 号：R737.9[医药卫生—肿瘤]