与接受全身治疗的非妊娠期乳腺癌患者相比,妊娠期乳腺癌化疗患者的疗效。

IF 6.1 2区 医学 Q1 ONCOLOGY Cancer Pub Date : 2024-10-29 DOI:10.1002/cncr.35619
Helen M Johnson, Juhee Song, Carla L Warneke, Ashley L Martinez, Jennifer K Litton, Oluchi C Oke
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引用次数: 0

摘要

导言:之前对妊娠期乳腺癌(PrBC)患者进行的研究报告结果不一,并受到治疗不达标、队列规模小和随访时间短的限制。这项研究比较了妊娠期接受化疗的PrBC患者与非妊娠期患者的生存结果,两者的年龄、确诊年份、分期和亚型相匹配:方法:1989年至2022年期间根据前瞻性机构方案接受治疗的PrBC患者均符合条件。采用卡普兰-梅耶法(Kaplan-Meier method)和多变量考克斯比例危险回归法(multivariable Cox proportional hazards regression)估算无病生存期(DFS)、总生存期(OS)和无进展生存期(PFS):在143名PrBC患者和285名非怀孕患者中,中位随访时间为11.4年。PrBC患者的中位DFS和OS分别为5.6年(95%置信区间[CI],3.6-15.4;P = .0001)和19.3年(95% CI,14.1-未估计;P = .0262),而未怀孕患者的中位DFS和OS则分别为5.6年和19.3年(95% CI,14.1-未估计;P = .0262)。PrBC患者的中位生存期为24.1年(95% CI,15.8-未估计),而非怀孕队列的中位生存期为8.4年(95% CI,6.4-10.9)(p = .0008)。在多变量分析中,研究队列与DFS、PFS和OS相关,非怀孕队列的疾病复发风险增加(危险比[HR],1.91;95% CI,1.33-2.76;p = .0005),疾病进展或死亡风险增加(HR,1.68;95% CI,1.19-2.39;p = .0035),OS缩短(HR,1.52;95% CI,1.01-2.29;p = .0442):这些数据表明,与年龄、癌症分期和亚型相似的非妊娠期患者相比,妊娠期接受化疗的PrBC患者的疗效至少相当,甚至更好。排除产后乳腺癌患者的分析无法进行,这也是未来确证研究的重点。
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Outcomes of patients treated with chemotherapy for breast cancer during pregnancy compared with nonpregnant breast cancer patients treated with systemic therapy.

Introduction: Prior studies of patients treated for breast cancer during pregnancy (PrBC) report mixed outcomes and are limited by substandard treatment, small cohorts, and short follow-up. This study compared survival outcomes of PrBC patients treated with chemotherapy during pregnancy with nonpregnant patients matched by age, year of diagnosis, stage, and subtype.

Methods: PrBC patients treated from 1989 to 2022 on prospective institutional protocols were eligible. Disease-free survival (DFS), overall survival (OS), and progression-free survival (PFS) were estimated using the Kaplan-Meier method and multivariable Cox proportional hazards regression.

Results: Among 143 PrBC and 285 nonpregnant patients, median follow-up was 11.4 years. Survival differences were statistically significant, with median DFS and OS not attained for PrBC patients versus 5.6 years (95% confidence interval [CI], 3.6-15.4; p = .0001) and 19.3 years (95% CI, 14.1-not estimated; p = .0262) for nonpregnant patients, respectively. Median PFS was 24.1 years (95% CI, 15.8-not estimated) for PrBC patients versus 8.4 years (95% CI, 6.4-10.9) for the nonpregnant cohort (p = .0008). Study cohort was associated with DFS, PFS, and OS in multivariable analyses, with the nonpregnant cohort having increased risks of disease recurrence (hazard ratio [HR], 1.91; 95% CI, 1.33-2.76; p = .0005) and disease progression or death (HR, 1.68; 95% CI, 1.19-2.39; p = .0035), and shorter OS (HR, 1.52; 95% CI, 1.01-2.29; p = .0442).

Conclusion: These data suggest that PrBC patients treated with chemotherapy during pregnancy have at least comparable, if not superior, outcomes than nonpregnant patients with similar age, cancer stage, and subtype. Analyses excluding patients with postpartum breast cancer were unable to be performed and are a priority for future confirmatory studies.

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来源期刊
Cancer
Cancer 医学-肿瘤学
CiteScore
13.10
自引率
3.20%
发文量
480
审稿时长
2-3 weeks
期刊介绍: The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society. CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research
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