85例颅外转移性乳腺癌放疗疗效观察及预后分析  

Clinical efficacy and prognosis of 85 patients with extracranial metastatic breast cancer receiving radiotherapy

作　　者：宋玉春 房辉 王淑莲 肖建平 唐玉 刘跃平 宋永文 陈波 亓姝楠 李宁 唐源 景灏 杨勇 任骅 赵瑞芝 卢宁宁 金晶 李晔雄 Song Yuchun;Fang Hui;Wang Shulian;Xiao Jianping;Tang Yu;Liu Yueping;Song Yongwen;Chen Bo;Qi Shunan;Li Ning;Tang Yuan;Jing Hao;Yang Yong;Ren Hua;Zhao Ruizhi;Lu Ningning;Jin Jing;Li Yexiong(Department of Radiation Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科,100021

出　　处：《中华放射肿瘤学杂志》2021年第6期569-574,共6页Chinese Journal of Radiation Oncology

基　　金：中国癌症基金会北京希望马拉松(LC2020A32)。

摘　　要：目的观察颅外转移性乳腺癌的放疗疗效,探讨全病变放疗意义及预后相关因素。方法回顾性分析2014—2019年间接受放疗的85例颅外转移性乳腺癌患者的临床资料,其中全病变放疗36例,非全病变放疗49例。采用Kaplan-Meier法计算生存率并log-rank检验和单因素预后分析,Cox模型多因素预后分析。结果全组中位随访时间26.7个月,2年局控(LC)、无进展生存(PFS)、总生存(OS)率分别为77%、26%、77%。全病变放疗预后显著优于非全病变放疗,2年LC率分别为91%和67%(P=0.001),2年PFS率分别为47%和8%(P<0.001),2年OS率分别为84%和71%(P=0.010)。多因素分析显示全病变放疗是LC、PFS、OS的独立预后因素。此外,接受放疗时是否仅有骨转移是LC的影响因素,激素受体状态是OS的影响因素。结论全病变放疗可以延长颅外转移性乳腺癌患者的生存。仅有骨转移的患者接受放疗后LC更佳,激素受体阴性的患者长期生存较差。Objective To evaluate the clinical efficacy of radiotherapy in the treatment of extracranial metastatic breast cancer,and to investigate the significance and prognostic factors of whole-lesion radiotherapy(WLRT).Methods Clinical data of 85 patients with extracranial metastatic breast cancer treated with radiotherapy between 2014 and 2019 were retrospectively analyzed.Thirty-six patients were assigned into the WLRT group and 49 in the non-WLRT group.The local control(LC),progression-free survival(PFS)and overall survival(OS)were calculated by Kaplan-Meier method,log-rank test and univariate prognostic analysis.Cox proportional hazards model was used for multivariate prognostic analysis.Results The median follow-up time was 26.7 months.The 2-year LC,PFS,OS rates were 77%,26%,77%,respectively.The 2-year LC(91%vs.67%,P=0.001),PFS(47%vs.8%,P<0.001),OS rates(84%vs.71%,P=0.010)in the WLRT group were significantly higher than those in the non-WLRT group,respectively.Multivariate analysis demonstrated that WLRT was an independent favorable prognostic factor for the LC,PFS and OS.Furthermore,bone metastasis alone was associated with improved LC and positive hormone receptor status was correlated with improved OS.Conclusions WLRT has the potential to prolong the survival of patients with extracranial metastatic breast cancer.The patients with bone metastases alone obtain better LC,whereas those with negative hormone receptor status has worse OS.

关 键 词：颅外转移 乳腺肿瘤/放射疗法 全病变 预后 

分 类 号：R737.9[医药卫生—肿瘤] R730.55[医药卫生—临床医学]