Risk factors for brain relapse in patients with metastatic breast cancer
Risk factors for brain relapse in patients with metastatic breast cancer
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DOI：
10.1093/annonc/mdh432
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发表时间：
2004-11-01
影响因子：
50.5
通讯作者：
Spielmann, M
中科院分区：
文献类型：
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作者：
Slimane, K;Andre, F;Spielmann, M
背景：脑转移的发生是转移性乳腺癌患者的一个新问题。在目前的研究中，我们观察了转移性乳腺癌患者脑转移的危险因素。患者和方法：首先在215例转移性乳腺癌患者中确定脑转移的危险因素。在199例转移性乳腺癌患者的确认性系列中，对多变量分析中确定的危险因素进行了重新评估。所有患者都纳入了前瞻性随机试验，以评估化疗或内分泌治疗在辅助治疗中的作用。结果：在第一个系列中，在多因素分析中，肺转移的存在（风险比=4.3,95% CI: 1.9-9.3， P=0.0003）和激素受体阴性状态（风险比=4.2,95% CI: 1.7-11， P=0.002）是与脑转移发生相关的唯一预测因素。第二个系列证实肺转移的存在和负激素受体状态与脑转移的发生有关。结论：肺转移作为复发的第一部位和激素受体阴性状态可预测转移性乳腺癌患者脑转移的发生。预防性治疗应在这些亚群患者中进行评估。
Background: The occurrence of brain metastases is an emerging problem in patients with metastatic breast cancer. In the present study, we looked at risk factors for brain metastasis among patients with metastatic breast cancer.Patients and methods: The risk factors for brain metastasis were first determined in a series of 215 patients with metastatic breast cancer. Risk factors identified in the multivariate analysis were re-evaluated in a confirmatory series of 199 patients with metastatic breast cancer. All the patients had been included in prospective randomized trials that evaluated chemotherapy or endocrine therapy in an adjuvant setting.Results: In the first series, the presence of lung metastases (hazard ratio =4.3, 95% CI: 1.9-9.3, P=0.0003) and negative hormone receptor status (hazard ratio=4.2, 95% CI: 1.7-11, P=0.002) were the only predictive factors associated with the occurrence of brain metastases in the multivariate analysis. The second series confirmed that the presence of lung metastases and negative hormone receptor status were associated with the occurrence of brain metastases.Conclusion: The presence of lung metastases as the first site of relapse and a negative hormone receptor status are predictive for the occurrence of brain metastases in patients with metastatic breast cancer. A prophylactic treatment should be evaluated in these subsets of patients.