HER2阳性乳腺癌患者曲妥珠单抗辅助治疗的回顾性生存分析
A retrospective survival analysis on Chinese HER2 positive breast cancer patients with adjuvant trastuzumab
目的 评价曲妥珠单抗辅助治疗对HER2阳性乳腺癌患者生存的影响.方法 对2005年1月至2015年8月间广东省人民医院肿瘤中心乳腺科收治的286例I~Ⅲ期HER2阳性乳腺癌患者进行回顾性分析.采用Kaplan-Meier法对患者进行生存分析,统计患者的无疾病生存情况(disease free survival,DFS)及总体生存情况(overall survival,OS).采用Log-rank检验进行因素间比较,COX回归模型进行多因素检验.结果 286例患者中位年龄49岁,Ⅰ期72例,Ⅱ期162例,Ⅲ期52例.按辅助曲妥珠单抗疗程分为三个亚组,分别为≥1年组(143例),9周且<1年组(22例)及<9周或从未使用组(121例).Kaplan-Meier生存分析结果显示,≥1年组的DFS及OS均明显优于其他两组(均P<0.05).三组的5年DFS率分别为92.4%,62.0%及72.1%,而5年OS率分别为96.0%,81.0%及80.0%.COX多因素回归分析结果表明,辅助曲妥珠单抗疗程为DFS及OS的独立预测因素(P<0.05),而至少1年的曲妥珠单抗辅助治疗可降低患者约80%的复发风险(HR=0.207,P<0.0001)与78%的死亡风险(HR =0.218,P=0.002).结论 足够疗程的曲妥珠单抗辅助治疗可以显著改善中国人群HER2阳性乳腺癌患者的长期生存.
更多Objective To evaluate adjuvant trastuzumab therapy on Chinese HER2 positive breast cancer patients.Methods A retrospective analysis was performed in 286 HER2 positive stage Ⅰ-Ⅲ patients from the Department of Breast Cancer of Guangdong General Hospital during Jan 2005 to Aug 2015.Disease-free survival(DFS) DFS and overall survival (OS) were analyzed with Kaplan-Meier method and Log-rank test.COX regression was applied to identify independent predicting factors.Results The median age was 49 years,and 72 were of stage Ⅰ,162 stage Ⅱ,52 stage Ⅲ.Patients were categorized into 3 groups according to the duration of adjuvant trastuzumab:≥ 1 year (143 patients),≥9 weeks < 1 year (22 patients),<9 weeks or never used (121 patients). DFS and OS in patients with ≥ 1 year adjuvant trastuzumab were significantly better than those in the other two groups (both P < 0.05).The estimated 5-year DFS of the 3 groups were 92.4%,62.0% and 72.1%,respectively.The estimated 5-year OS were 96.0%,81.0% and 80.0%,respectively.Adjuvant trastuzumab was independent predicting factors for DFS and OS (both P < 0.05),while at least 1-year adjuvant trastuzumab approximately reduced the risk of relapse by 80% (HR =0.207,P < 0.0001) and reduced the risk of death by 78% (HR =0.218,P =0.002).Conclusions Adequate duration of adjuvant trastuzumab can significantly improve the long-term survival of Chinese HER2 positive breast cancer patients.
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