In real life, one-quarter of patients with hormone receptor-positive metastatic breast cancer receive chemotherapy as initial palliative therapy: a study of the Southeast Netherlands Breast Cancer Consortium
In real life, one-quarter of patients with hormone receptor-positive metastatic breast cancer receive chemotherapy as initial palliative therapy: a study of the Southeast Netherlands Breast Cancer Consortium
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DOI：
10.1093/annonc/mdv544
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发表时间：
2016-02-01
影响因子：
50.5
通讯作者：
Tjan-Heijnen, V. C. G.
中科院分区：
文献类型：
--
作者：
Lobbezoo, D. J. A.;van Kampen, R. J. W.;Tjan-Heijnen, V. C. G.
背景资料：本研究的目的是提出初步的系统性治疗选择和激素受体阳性（HR+）转移性breast cancer.Patients和方法的结果：所有的815例连续诊断为转移性乳腺癌在2007-2009年在8家参与医院被确定。在611例HR+疾病患者中，共纳入520例HER 2阴性（HER 2-）乳腺癌患者。登记了初始姑息性全身治疗。无进展生存期（PFS）和总生存期（OS）每个初始姑息性全身治疗使用Kaplan-Meier方法和比较使用log-rank test.Results：从总的520例HR+/HER 2-转移性乳腺癌，482例（93%）接受任何姑息性全身治疗。与接受初始内分泌治疗的患者（n = 366）相比，接受初始化疗的患者（n = 116）明显更年轻，合并症更少，既往接受过更多的辅助全身治疗，仅发生骨转移的可能性更低。初始姑息化疗的中位PFS为5.3个月[95%置信区间（CI）4.2-6.2]，初始内分泌治疗为13.3个月（95% CI 11.3-15.5），中位OS分别为16.1和36.9个月。初始化疗也与不良结局PFS和OS调整预后factors.Conclusions：高比例的HR+疾病患者接受初始姑息化疗，这是与不良结局，即使调整相关的预后因素。
Background: The objective of this study was to present initial systemic treatment choices and the outcome of hormone receptor-positive (HR+) metastatic breast cancer.Patients and methods: All the 815 consecutive patients diagnosed with metastatic breast cancer in 2007-2009 in eight participating hospitals were identified. From the 611 patients with HR+ disease, a total of 520 patients with HER2-negative (HER2-) breast cancer were included. Initial palliative systemic treatment was registered. Progression-free survival (PFS) and overall survival (OS) per initial palliative systemic therapy were obtained using the Kaplan-Meier method and compared using the log-rank test.Results: From the total of 520 patients with HR+/HER2-metastatic breast cancer, 482 patients (93%) received any palliative systemic therapy. Patients that received initial chemotherapy (n = 116) were significantly younger, had less comorbidity, had received more prior adjuvant systemic therapy and were less likely to have bone metastasis only compared with patients that received initial endocrine therapy (n = 366). Median PFS of initial palliative chemotherapy was 5.3 months [95% confidence interval (CI) 4.2-6.2] and of initial endocrine therapy 13.3 months (95% CI 11.3-15.5), with a median OS of 16.1 and 36.9 months, respectively. Initial chemotherapy was also associated with worse outcome in terms of PFS and OS after adjustment for prognostic factors.Conclusions: A high percentage of patients with HR+ disease received initial palliative chemotherapy, which was associated with worse outcome, even after adjustment of relevant prognostic factors.