76例乳腺癌脑转移患者临床特征及预后因素分析

A Retrospective Analysis of Clinical Features and Prognostic Factors for 76 Cases of Breast Cancer with Brain Metastasis

目的分析乳腺癌脑转移患者临床病理特征,探讨影响乳腺癌脑转移患者的预后因素。方法收集76例乳腺癌脑转移患者的临床病理资料,采用单因素和多因素分析影响乳腺癌脑转移患者的预后因素。结果乳腺癌患者确诊脑转移后中位生存期为8.4个月,1年生存率为31.6%,2年生存率为7.9%,3年生存率为3.9%。多因素分析提示未放疗、PS评分≥2分、多发颅内转移灶、分子分型为Her-2型及三阴型均是乳腺癌脑转移患者的不良预后因素。Luminal A、Luminal B、Her-2型及三阴型乳腺癌患者中位无脑转移生存期(46.8个月、34个月、26.8个月和17.6个月,P=0.005)、确诊脑转移后生存期(16.9个月、9.5个月、7.6个月和5.5个月,P=0.001)和总生存期(64.3个月、40.9个月、31.7个月和24.1个月,P=0.001)差异均有统计学意义。结论放疗、PS评分、脑转移灶数目及分子分型是影响乳腺癌脑转移患者的独立预后因素;与Luminal型乳腺癌相比,Her-2型及三阴型乳腺癌更易早期发生脑转移,且生存期更短。

Objective To investigate the clinical characteristics and prognosis of breast cancer patients with brain metas- tasis. Methods The clinical features of 76 breast cancer patients with brain metastasis were collected, prognostic factors were analyzed by univariate and multivariate survival analysis. Results The median survival from brain metastasis was 8.4 months, and the 1-,2-, 3-year overall survival were 31.6 % ,7.9%, 3.9%, respectively. Multivariate analysis showed that without brain radiothera- py, performance status ≥2, multiple brain metastases, her-2 subtype and triple negative subtype were associated with poor progno- sis. The patients were divided into Luminal A, Luminal B, Her-2 and triple negative subtypes. The median brain disease-free sur- vival were 46.8,34,26.8 and 17.6 months （P = 0. 005 ） among the 4 types. The median survival from brain metastasis were 16.9,9.5,7.6 and 5.5months （ P = 0. 001 ） among the 4 types. The median overall survival （OS） were 64.3,40.9,31.7 and 24.1 months （ P = 0.001 ） among the 4 types. Conclusion Radiotherapy, performance status, the number of brain metastasis and molecular type are independent prognostic factors of breast cancer patients with brain metastasis. Compared with Luminal type breast cancer, Her-2 type and triple negative breast cancer patients are more prone to metastasize to brain and suffer a shorter median survival.