98例乳腺癌肝转移患者的回顾性研究分析

背景与目的:乳腺癌肝转移患者预后不良,对化疗敏感性差,化疗缓解期短,生存期短.如何提高乳腺癌肝转移的治疗效果、延长患者的生存期,是目前临床研究中亟需解决的问题.本研究回顾性分析影响乳腺癌肝转移患者预后的因素,并探讨化疗及肝动脉栓塞灌注化疗治疗乳腺癌肝转移的疗效.方法:回顾性分析1996～2005年间98例乳腺癌肝转移的临床资料,采用多因素分析方法(Cox模型)分析乳腺癌肝转移患者的临床特征、治疗方法及与预后的关系,并比较不同治疗方法的疗效.结果:98例乳腺癌肝转移患者,治疗的总有效率为45.9%(45/98),单纯全身化疗组有效率为48.6%(36/74),单纯肝动脉栓塞灌注化疗组为23.1%(3/13),全身化疗加肝动脉栓塞灌注化疗组为54.6%(6/11).全组中位随访期17个月(3～56个月),中位无疾病进展时间为6个月(0～50个月),中位生存期为17个月(3～56个月).1、2、3、4年生存率分别为36.0%、19.0%、13.0%和3.0%.结论:采用全身化疗加肝动脉栓塞灌注化疗治疗乳腺癌肝转移疗效较好,值得在仅有肝转移的晚期乳腺癌患者中作进一步研究.多因素分析结果表明,术后至发生肝转移时间少于24个月、姑息化疗疗程数少于6个是预后危险因素.

Retrospective analysis of 98 cases of breast cancer with liver metastasis

BACKGROUND & OBJECTIVE: The prognosis of breast cancer patients with liver metastasis is poor. How to improve treatment efficacy and prolong survival of these patients is a challenge in clinic. This study was to explore the efficacy of chemotherapy and transcatheter arterial chemoembolization (TACE) on breast cancer patients with liver metastasis, and analyze prognostic factors. METHODS: Clinical data of 98 breast cancer patients with liver metastasis, treated from 1996 to 2005 in Cancer Center of Sun Yat-sen University, were analyzed retrospectively. The prognostic factors correlated to clinical features and treatment approaches were determined using Cox multivariate model. RESULTS: The total response rate was 45.9% for all patients, 48.6% for the 74 patients received systemic chemotherapy, 23.1% for the 13 patients received TACE, and 54.6% for the 11 patients received chemotherapy plus TACE. At a median follow-up of 17 months (3-56 months), the 1-, 2-, 3-, and 4-year survival rates were 36%, 19%, 13%, and 3%, respectively; the median survival was 17 months (3-56 months), and the progression-free survival was 6 months (0-50 months). CONCLUSION: The combination of systemic chemotherapy and TACE may prolong the survival of breast cancer patients with liver metastasis.