乳腺癌骨转移内分泌治疗与化疗的对比研究

Comparison of endocrine therapy and chemotherapy for bone metastasis of breast cancer

目的 对比分析内分泌治疗与化疗对乳腺癌骨转移的疗效。方法 对 138例无内脏转移的乳腺癌骨转移患者 ,行 2 89例次单独内分泌治疗或化疗。结果 内分泌治疗与化疗的一线治疗有效率分别为 35 .4 %和 31.7% ,差异无显著性 (χ2 =0 .16 3,P =0 .6 87) ;全部治疗有效率分别为 2 7.1%和 2 5 .0 % ,差异无显著性 (χ2 =0 .15 9,P =0 .6 90 ) ;临床获益率分别为 4 3.9%和 36 .6 % ,差异无显著性(χ2 =0 .6 0 3,P =0 .4 37)。但内分泌治疗与化疗的二线治疗临床获益率分别为 4 7.8%和 2 4 .2 % ,全部治疗为 4 7.5 %和 2 7.7% ,差异均有显著性 (χ2 =4 .5 37,P =0 .0 33;χ2 =11.2 0 1,P =0 .0 0 1)。内分泌治疗和化疗患者的中位治疗失败时间 (TTF)为 5个月和 2个月 ,中位病变进展时间 (TTP)为 5个月和 2 .5个月 ,差异均有非常显著性 (P均 <0 .0 0 1)。结论 单独内分泌治疗和化疗均为乳腺癌骨转移的有效治疗手段 ,其中内分泌治疗优于化疗。

ObjectiveTo compare the efficacy of endocrine therapy with chemotherapy for bone metastasis of breast cancer. MethodsA total of 138 breast cancer patients with bone metastasis, but without visceral metastasis as retrospectively reviewed. ResultsThe response rates of endocrine therapy and chemotherapy as the first-line therapy were 35.4% and 31.7% ( P =0.687), and the total response rates were 27.1% and 25.0% ( P =0.690). The clinical benefit rates of endocrine therapy and chemotherapy as first-line were 43.9% and 36.6% ( P =0.437), as second-line were 47.8% and 24.2% ( P =0.033), in total treatments were 47.5% and 27.7% ( P =0.001). The median interval to treatment failure (TTF) was 5 months and 2 months ( P <0.001) , and that to progression (TTP) was 5 and 2.5 months ( P <0.001) in endocrine therapy and chemotherapy group, respectively. ConclusionEndocrine therapy is superior to chemotherapy for bone metastasis of breast cancer.