一个风险分层模型来预测乳腺髓癌中化疗的益处:基于人口的SEER数据库
Heyan Chen1, Shengyu Pu1, Lizhao Wang1
1Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.
Scientific reports
|July 3, 2023
概括
化疗对低风险组中髓性乳腺癌 (MBC) 患者有益,改善整体存活率 (OS). 然而,证据不支持其对高危MBC患者的益处,建议仔细选择和进一步的临床试验.
科学领域:
- 在瘤学瘤学.
- 医学统计 医学统计
- 临床研究 临床研究
背景情况:
- 化疗在骨髓性乳腺癌 (MBC) 治疗中的作用仍然存在争议.
- 确定从化疗中受益的MBC患者对于个性化治疗策略至关重要.
- 现有的数据缺乏关于不同MBC风险层的化疗疗效果的明确指导方针.
研究的目的:
- 为了确定骨髓性乳腺癌 (MBC) 患者整体生存期 (OS) 的预后因素.
- 开发一种名谱,用于预测MBC患者的OS.
- 评估化疗对MBC患者不同风险组的生存系统的影响.
主要方法:
- 从SEER数据库 (2010-2018) 中对618名骨髓性乳腺癌 (MBC) 患者进行了回顾性分析.
- 考克斯回归分析以确定独立的预后因素;使用AUC和校准图表构建和验证nomogram.
- 卡普兰-梅尔曲线用于评估化疗在不同风险组中的OS益处,这些风险组通过一种新的风险分类系统进行分层.
主要成果:
- 纳米图包括年龄,T阶段,N状态,亚型和辐射,有效预测了3年和5年的OS率 (AUC从0.781到0.823不等).
- 化疗在低风险MBC组 (p < 0.001) 中显示了统计学上显著的OS益处.
- 在高风险的MBC组中,没有观察到化学疗法的统计学上显著的OS益处 (p = 0.180).
结论:
- 经过验证的乳房图可以帮助预测骨髓性乳腺癌 (MBC) 患者的生存状况.
- 化疗可能会改善低风险MBC患者的生存状况,但其对高风险患者的益处没有得到当前证据的支持.
- 对高危MBC患者的化疗治疗决策需要仔细考虑,需要进一步的临床试验来确认潜在的豁免.
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