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Lancet:二磷酸盐可减少乳腺癌骨转移

2015-10-18 Mechront 译 MedSci原创

磷酸盐可以对骨骼的生理产生影响,从而修改转移的过程。研究者为探究二磷酸盐辅助治疗乳腺癌的利和弊,进行了一项荟萃分析。研究者纳入早期乳腺癌患者,随机分为二磷酸盐组和对照组。以复发、远处转移、乳腺癌死亡率作为初始结局指标。以下情况分亚组:远处转移位置(骨或其他)、月经状态 (自然或人工绝经后、非绝经)、二磷酸盐类别(亚甲基氨基二膦酸盐或其他)。研究共纳入18,766名女性,其中18,206 [97%]

磷酸盐可以对骨骼的生理产生影响,从而修改转移的过程。研究者为探究二磷酸盐辅助治疗乳腺癌的利和弊,进行了一项荟萃分析。

研究者纳入早期乳腺癌患者,随机分为二磷酸盐组和对照组。以复发、远处转移、乳腺癌死亡率作为初始结局指标。以下情况分亚组:远处转移位置(骨或其他)、月经状态 (自然或人工绝经后、非绝经)、二磷酸盐类别(亚甲基氨基二膦酸盐或其他)。

研究共纳入18,766名女性,其中18,206 [97%]的女性使用了2-5年的二磷酸盐治疗,平均随访5.6人年,期间有3453例第一次复发,其中2106发生死亡。整体上看,复发率 (RR 0.94, 95% CI 0.87-1.01; 2p=0.08)、远处转移(0.92, 0.85-0.99; 2p=0.03),和乳腺癌死亡率(0.91, 0.83-0.99; 2p=0.04)的降低均只有边缘意义,不过对于骨转移风险的下降却有确切意义 (0.83, 0.73-0.94; 2p=0.004)。

对于未绝经妇女,该治疗对结局并没有什么影响,不过对11 767名绝经后女性的随访中发现,二磷酸盐治疗可以显著减少复发(0.72, 0.60-0.86; 2p=0.0002),以及减少乳腺癌死亡率 (0.82, 0.73-0.93; 2p=0.002)。骨转移、月经状态(2p=0.06) 和年龄(2p=0.03)对其影响不大,并且二磷酸盐类别、疗程、雌激素受体情况、淋巴结转移情况、肿瘤分期分级、是否接受化疗等均与研究结果关系不大。二磷酸盐治疗与否不会影响非乳腺癌造成的死亡,同时还可以降低骨折风险(RR 0.85, 95% CI 0.75-0.97; 2p=0.02)。

研究结果表明,二磷酸盐辅助治疗乳腺癌可以减少骨转移以及改善乳腺癌生存率,不过目前研究来看,仅仅是针对绝经后开始治疗的女性。

原始出处:

Early Breast Cancer Trialists' Collaborative Group (EBCTCG), Coleman R, Powles T,et al.Adjuvant bisphosphonate treatment in early breast cancer: meta-analyses of individual patient data from randomised trials.Lancet. 2015 Oct 3;386(10001):1353-61.

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    2016-01-24 howi
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    2015-10-22 1dde30e9m65(暂无匿称)

    感谢!

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1828250, encodeId=3a6f182825037, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun Jan 24 07:43:00 CST 2016, time=2016-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2024511, encodeId=3aa82024511c1, content=<a href='/topic/show?id=606523999e4' target=_blank style='color:#2F92EE;'>#二磷酸盐#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23999, encryptionId=606523999e4, topicName=二磷酸盐)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Sun Nov 08 10:43:00 CST 2015, time=2015-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=40353, encodeId=a9d940353d8, content=感谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=630a1658507, createdName=1dde30e9m65(暂无匿称), createdTime=Thu Oct 22 23:47:00 CST 2015, time=2015-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459908, encodeId=32de145990836, content=<a href='/topic/show?id=e50ce3859fe' target=_blank style='color:#2F92EE;'>#磷酸盐#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73859, encryptionId=e50ce3859fe, topicName=磷酸盐)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d8ea6208793, createdName=chenshujs, createdTime=Tue Oct 20 13:43:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39692, encodeId=6e2e39692c8, content=感谢分享~, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:49:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39693, encodeId=8be73969374, content=非常感谢~, beContent=null, objectType=article, channel=null, level=null, likeNumber=188, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:49:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39694, encodeId=296f3969485, content=为了积分我也是拼了~, beContent=null, objectType=article, channel=null, level=null, likeNumber=190, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:49:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39691, encodeId=ab4d3969143, content=赞一个~, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:48:00 CST 2015, time=2015-10-19, status=1, ipAttribution=)]
    2015-10-19 sunlong28

    感谢分享~

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1828250, encodeId=3a6f182825037, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun Jan 24 07:43:00 CST 2016, time=2016-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2024511, encodeId=3aa82024511c1, content=<a href='/topic/show?id=606523999e4' target=_blank style='color:#2F92EE;'>#二磷酸盐#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23999, encryptionId=606523999e4, topicName=二磷酸盐)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Sun Nov 08 10:43:00 CST 2015, time=2015-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=40353, encodeId=a9d940353d8, content=感谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=630a1658507, createdName=1dde30e9m65(暂无匿称), createdTime=Thu Oct 22 23:47:00 CST 2015, time=2015-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459908, encodeId=32de145990836, content=<a href='/topic/show?id=e50ce3859fe' target=_blank style='color:#2F92EE;'>#磷酸盐#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73859, encryptionId=e50ce3859fe, topicName=磷酸盐)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d8ea6208793, createdName=chenshujs, createdTime=Tue Oct 20 13:43:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39692, encodeId=6e2e39692c8, content=感谢分享~, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:49:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39693, encodeId=8be73969374, content=非常感谢~, beContent=null, objectType=article, channel=null, level=null, likeNumber=188, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:49:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39694, encodeId=296f3969485, content=为了积分我也是拼了~, beContent=null, objectType=article, channel=null, level=null, likeNumber=190, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:49:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39691, encodeId=ab4d3969143, content=赞一个~, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:48:00 CST 2015, time=2015-10-19, status=1, ipAttribution=)]
    2015-10-19 sunlong28

    非常感谢~

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1828250, encodeId=3a6f182825037, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun Jan 24 07:43:00 CST 2016, time=2016-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2024511, encodeId=3aa82024511c1, content=<a href='/topic/show?id=606523999e4' target=_blank style='color:#2F92EE;'>#二磷酸盐#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23999, encryptionId=606523999e4, topicName=二磷酸盐)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Sun Nov 08 10:43:00 CST 2015, time=2015-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=40353, encodeId=a9d940353d8, content=感谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=630a1658507, createdName=1dde30e9m65(暂无匿称), createdTime=Thu Oct 22 23:47:00 CST 2015, time=2015-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459908, encodeId=32de145990836, content=<a href='/topic/show?id=e50ce3859fe' target=_blank style='color:#2F92EE;'>#磷酸盐#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73859, encryptionId=e50ce3859fe, topicName=磷酸盐)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d8ea6208793, createdName=chenshujs, createdTime=Tue Oct 20 13:43:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39692, encodeId=6e2e39692c8, content=感谢分享~, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:49:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39693, encodeId=8be73969374, content=非常感谢~, beContent=null, objectType=article, channel=null, level=null, likeNumber=188, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:49:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39694, encodeId=296f3969485, content=为了积分我也是拼了~, beContent=null, objectType=article, channel=null, level=null, likeNumber=190, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:49:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39691, encodeId=ab4d3969143, content=赞一个~, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:48:00 CST 2015, time=2015-10-19, status=1, ipAttribution=)]
    2015-10-19 sunlong28

    为了积分我也是拼了~

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1828250, encodeId=3a6f182825037, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun Jan 24 07:43:00 CST 2016, time=2016-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2024511, encodeId=3aa82024511c1, content=<a href='/topic/show?id=606523999e4' target=_blank style='color:#2F92EE;'>#二磷酸盐#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23999, encryptionId=606523999e4, topicName=二磷酸盐)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Sun Nov 08 10:43:00 CST 2015, time=2015-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=40353, encodeId=a9d940353d8, content=感谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=630a1658507, createdName=1dde30e9m65(暂无匿称), createdTime=Thu Oct 22 23:47:00 CST 2015, time=2015-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459908, encodeId=32de145990836, content=<a href='/topic/show?id=e50ce3859fe' target=_blank style='color:#2F92EE;'>#磷酸盐#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73859, encryptionId=e50ce3859fe, topicName=磷酸盐)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d8ea6208793, createdName=chenshujs, createdTime=Tue Oct 20 13:43:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39692, encodeId=6e2e39692c8, content=感谢分享~, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:49:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39693, encodeId=8be73969374, content=非常感谢~, beContent=null, objectType=article, channel=null, level=null, likeNumber=188, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:49:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39694, encodeId=296f3969485, content=为了积分我也是拼了~, beContent=null, objectType=article, channel=null, level=null, likeNumber=190, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:49:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39691, encodeId=ab4d3969143, content=赞一个~, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 17:48:00 CST 2015, time=2015-10-19, status=1, ipAttribution=)]
    2015-10-19 sunlong28

    赞一个~

    0

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