氟维司群单药对激素受体阳性复发、转移性乳腺癌患者疗效的单中心分析  

Efficacy of fulvestrant monotherapy for hormonal receptor-positive recurrent or metastatic breast cancer:a single center analysis

作　　者：李晶晶[1] 王小磊[1] 任鹏飞 杨震[1] 陈婵娟[1] 琚倩 李烦繁[1] Li Jingjing;Wang Xiaolei;Ren Pengfei;Yang Zhen;Chen Chanjuan;Ju Qian;Li Fanfan(Department of Oncology,Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院肿瘤科,合肥230601

出　　处：《中华乳腺病杂志（电子版）》2020年第3期150-155,共6页Chinese Journal of Breast Disease(Electronic Edition)

基　　金：安徽高校自然科学基金资助项目(KJ2019A0258)。

摘　　要：目的 回顾性分析氟维司群单药治疗激素受体阳性复发、转移性乳腺癌患者的疗效及其与临床病理特征的相关性.方法 收集2017年8月至2019年8月在安徽医科大学第二附属医院治疗的激素受体阳性乳腺癌患者的临床资料.选取既往接受过辅助内分泌治疗,且在复发、转移后接受过氟维司群单药治疗的患者52例,采用Kaplan-Meier法计算氟维司群单药治疗的无进展生存期(PFS),采用log-rank法分析各临床病理因素对PFS的影响.将单因素分析差异有统计学意义的变量纳入多因素Cox回归模型进行分析,得到影响氟维司群疗效的独立危险因素.结果 52例患者的中位随访时间为15.2个月(范围:10.9~19.0个月),中位PFS为8.3个月(95%CI:5.5~10.4个月).30例早复发(辅助内分泌治疗过程中或辅助内分泌治疗结束后≤1年复发或转移)与22例晚复发(完成辅助内分泌治疗结束后>1年复发或转移)患者的中位PFS分别为6.3个月(95%CI:4.5~7.5个月)和13.4个月(95%CI:7.7~18.3个月),差异有统计学意义(χ2=9.280,P=0.002).21例有肝转移与31例无肝转移患者的中位PFS分别为5.0个月(95%CI:3.9~6.1个月)和10.3个月(95%CI:6.4~13.6个月),差异有统计学意义(χ2=7.544,P=0.006).25例复发或转移后接受化疗与27例未接受化疗患者的中位PFS分别为5.2个月(95%CI:3.7~6.3个月)和11.3个月(95%CI:8.5~13.5个月),差异有统计学意义(χ2=7.305,P=0.007).45例PR阳性与7例PR阴性患者的中位PFS分别为9.0个月(95%CI:6.3~11.7个月)和4.2个月(95%CI:2.8~5.1个月),差异有统计学意义(χ2=6.869,P=0.009).Cox多因素分析显示复发时间短和复发、转移后接受化疗是影响氟维司群疗效的独立危险因素(HR=3.474,95%CI:1.534~7.866,P=0.003;HR=2.822,95%CI:1.349~5.9,P=0.006).结论 既往接受辅助内分泌治疗的激素受体阳性复发、转移性乳腺癌患者接受氟维司群单药治疗时,复发晚、既往未接受化疗和无肝转移的患者获益更大.Objective To retrospectively analyze the efficacy of fulvestrant monotherapy for hormonal receptor(HR)-positive recurrent or metastatic breast cancer and its relationship with clinicopathological features.Methods The clinical data of HR-positive breast cancer patients in the Second Affiliated Hospital of Anhui Medical University from August 2017 to August 2019 were collected.Among them,52 patients who had history of adjuvant endocrine therapy and underwent fulvestrant monotherapy after recurrence and metastasis were enrolled into this study.Kaplan-Meier method was used to calculate the progression-free survival(PFS)of patients after fulvestrant monotherapy and log-rank test was used to analyze the effect of clinicopathological features on PFS.The significant factors in univariate analysis were included in the multivariate Cox regression model to screen out independent risk factors.Results All patients were followed up for 10.9-19.0 months(median 15.2 months).The median PFS of 52 patients was 8.3 months(95%CI:5.5-10.4 months).The median PFS was 6.3 months(95%CI:4.5-7.5 months)in 30 patients with early recurrence(disease recurrence during adjuvant endocrine therapy or within 12 months after adjuvant endocrine therapy)and 13.4 months(95%CI:7.7-18.3 months)in 22 patients with late recurrence(disease recurrence over 12 months after adjuvant endocrine therapy),indicating a significant difference(χ2=9.280,P=0.002).The median PFS was 5.0 months(95%CI:3.9-6.1 months)in 21 patients with liver metastasis and 10.3 months(95%CI:6.4-13.6 months)in 31 patients without liver metastasis,indicating a significant difference(χ2=7.544,P=0.006).The median PFS was 5.2 months(95%CI:3.7-6.3 months)in 25 patients with chemotherapy after recurrence or metastasis and 11.3 months(95%CI:8.5-13.5 months)in 27 patients without chemotherapy,indicating a significant difference(χ2=7.305,P=0.007).The median PFS was 9.0 months(95%CI:6.3-11.7 months)in 45 PR-positive patients and 4.2 months(95%CI:2.8-5.1 months)in 7 PR-negative patients,indicating

关 键 词：乳腺肿瘤 肿瘤转移 药物疗法 雌激素受体拮抗剂 

分 类 号：R737.9[医药卫生—肿瘤]