乳腺癌脑转移的时间演变 治疗方法和结果
Michele Bottosso1,2, Gaia Griguolo1,2, Severine Guiu3
1Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, IT, Italy.
NPJ breast cancer
|February 20, 2025
概括
乳腺癌中大脑转移的管理已经发展,随着增加的立体辐射疗法和抗HER2疗法. 只有HR-/HER2+患者的生存率有所改善,这与向治疗有关.
科学领域:
- 在瘤学瘤学.
- 神经瘤学神经瘤学
- 乳腺癌研究研究 乳腺癌研究
背景情况:
- 大脑转移 (BMs) 是晚期乳腺癌 (BC) 的常见并发症.
- 在过去的二十年中,BCBM的管理策略经历了显著的演变.
- 了解这些不断变化的管理策略的临床影响对于改善患者的治疗结果至关重要.
研究的目的:
- 评估不断发展的管理策略对被诊断为乳腺癌脑转移 (BCBMs) 的患者的临床影响.
- 分析不同时间段治疗方式的变化及其与整体存活率 (OS) 的相关性.
- 确定受益于最近治疗进步的患者子组.
主要方法:
- 在三所机构对2000年至2022年间诊断的BCBM患者的回顾性分析.
- 根据诊断年份,患者被分为三组:2000-2007年 (A组),2008-2014年 (B组) 和2015-2022年 (C组).
- 评估了放射治疗 (立体辐射疗法与全脑辐射疗法) 和全身疗法 (特别是抗HER2疗法) 的趋势,以及它们与OS的关联.
主要成果:
- 立体辐射疗法的使用量显著增加,而全脑辐射疗法随着时间的推移而减少.
- 近年来,在HER2+BC患者中,使用抗HER2治疗后的BM诊断增加了.
- 整体存活率 (OS) 在整个队列中没有改善,但在HR-/HER2+BC患者中显著改善 (A,B,C组的中位数OS:8.7,10.1,23.7个月;P=.002).
- 近年来,HER2阳性成为一个重要的预后因素 (C组),而前几年 (A组) 则不是.
结论:
- 在过去的二十年中,BCBM的治疗方法发生了重大变化,转向了更有针对性的疗法和先进的放射治疗技术.
- 仅在HR-/HER2+亚组中观察到整体生存益处,这可能归因于具有内活性的抗HER2疗法的疗效增加.
- 这些发现凸显了亚型特异性治疗策略的重要性,以及针对性疗法在治疗乳腺癌脑转移中的日益增长的影响.
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