CAJ | 학술논문

目的探讨乳腺癌肾上腺转移患者的临床病理特征、治疗方式和预后.方法回顾性分析1999年1月至2010年12月间就诊的34例乳腺癌肾上腺转移患者的临床病理特征和治疗方式.结果 34例乳腺癌肾上腺转移患者中,有32例患者接受化疗,其中部分缓解(PR)11例(34.4％),疾病稳定(SD)10例(31.2％),疾病进展(PD)8例(25.0％),临床获益率为61.8％.在11例获得PR的患者中,有2例为一线化疗,6例为二线化疗,2例为三线化疗,1例为四线化疗,并且有9例肾上腺病灶均存在不同程度的缩小.乳腺癌肾上腺转移患者的中位疾病进展时间(TTP)为6.2个月(95％CI为3.1 ～9.3个月),中位总生存时间为21.3个月(95％ CI为0～44.0个月).在34例乳腺癌肾上腺转移患者中,化疗疗效达PR和SD患者的中位TTP(18.1个月)显著优于PD患者(2.3个月,P＜0.001),接受一线和二线化疗患者的中位TTP(15.7个月)显著优于接受三线及以上患者(4.2个月,P =0.005),化疗疗效达PR和SD患者的中位总生存时间(35.2个月)亦显著优于PD患者(10.3个月,P=0.003).结论乳腺癌肾上腺转移发生率较低,患者预后不良,但仍应积极地进行以全身治疗为主的综合治疗.
목적 탐토유선암신상선전이환자적림상병리특정、치료방식화예후.방법 회고성분석1999년1월지2010년12월간취진적34례유선암신상선전이환자적림상병리특정화치료방식.결과 34례유선암신상선전이환자중,유32례환자접수화료,기중부분완해(PR)11례(34.4％),질병은정(SD)10례(31.2％),질병진전(PD)8례(25.0％),림상획익솔위61.8％.재11례획득PR적환자중,유2례위일선화료,6례위이선화료,2례위삼선화료,1례위사선화료,병차유9례신상선병조균존재불동정도적축소.유선암신상선전이환자적중위질병진전시간(TTP)위6.2개월(95％CI위3.1 ～9.3개월),중위총생존시간위21.3개월(95％ CI위0～44.0개월).재34례유선암신상선전이환자중,화료료효체PR화SD환자적중위TTP(18.1개월)현저우우PD환자(2.3개월,P＜0.001),접수일선화이선화료환자적중위TTP(15.7개월)현저우우접수삼선급이상환자(4.2개월,P =0.005),화료료효체PR화SD환자적중위총생존시간(35.2개월)역현저우우PD환자(10.3개월,P=0.003).결론 유선암신상선전이발생솔교저,환자예후불량,단잉응적겁지진행이전신치료위주적종합치료.
Objective To evaluate the clinical characteristics and prognosis of adrenal metastasis from breast cancer,and to explore methods to improve prognosis.Methods Thirty-four breast cancer patients with adrenal metastasis were diagnosed and treated in our hospital from Jan.1999 to Dec.2010.SPSS 17.0 was used for survival analysis.Results During the Jan.1999 to Dec.2010 period,13 595 patients with breast cancer were treated in our hospital.Among them,34 cases had adrenal metastasis from breast cancer,with an incidence of 0.25％.The median time to progression (TTp) and overall survival of the 34 patients was 6.2 months (95％ CI 3.1-9.3 months) and 21.4 months (95％ CI 0-44.0 months),respectively.Eleven patients (34.4％) achieved partial response among 32 patients who received chemotherapy,and 10 (31.2％) achieved stable disease.Patients who achieved best response of PR or SD were superior in TTP and OS than patients with disease progression after chemotherapy (TTP:18.1 months vs.2.3 months,P ＜0.001 ; OS:35.2 months vs.10.3 months,P =0.003).Patients who received 1st or 2nd line chemotherapy were superior in TTP than patients who received over 2nd line chemotherapy (TTP:15.7 months vs.4.2 months,P =0.005).Conclusions The incidence of adrenal metastasis from breast cancer is low.Chemotherapy-based systemic therapy should be recommended to improve the prognosis for these patients.