【作者】 王爱娟；

【导师】 沈朋；

【作者基本信息】 浙江大学 ， 肿瘤学， 2011， 硕士

【摘要】 目的：乳腺癌是女性最常见的恶性肿瘤。乳腺癌肝转移是一项独立的预后不良因素。多学科综合治疗能达到缓解症状,延长生存时间的目的。本文主要研究乳腺癌肝转移患者的临床特征、治疗的疗效评估及预后相关因素。方法：回顾性分析2008年1月至2011年1月浙江大学医学院附属第一医院肿瘤科收治的30例乳腺癌肝转移患者的临床特征、治疗过程、疗效评价及生存情况。结果：本文对30例乳腺癌肝转移患者进行分析。所有患者均为女性,发病年龄35-65岁,中位年龄53岁。其中起病年龄、TNM分期、ER状态与无进展生存期具有明显相关性。肿瘤大小、淋巴结转移数目、是否绝经对无进展生存期有影响,但未达到统计学意义。对于乳腺癌肝转移患者药物治疗联合局部治疗,肝转移后生存时间长于药物治疗组(分别为28.5月和32.8月),1年生存率分别为73.5%和87.5%；药物治疗联合局部治疗组肝转移后生存时间有延长趋势。肝脏首发转移较其他部位首发转移预后差(复发转移后中位生存时间分别为29.2月和73.2月,P=0.044)。结论：乳腺癌肝转移预后较差。全身治疗联合局部治疗是乳腺癌肝转移患者的一个有效治疗方式。更多还原

【Abstract】 Objective:Breast cancer is one of the most common malignant cancers of women. 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. The study aim is to explore the clinical characteristics, therapeutic strategies and prognosis agents of breast cancer liver metastasis patients.Methods:The tolal of 30 breast cancer patients with liver metastasis admitted to the Department of Medical Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University from Mar.2008 to Mar.2011 were studied. The data of patients were gathered, including clinical characteristics, pathological diagnosis, ER status, PR status, HER2 status, staging, adjuvant treatments,palliative treatments and survival agents.Results:30 patients were admitted into the study. The Median age of patients was 53.4 years, range from 35 years to 65 years. Firstly, we analysis the clinical characteristics ofⅠ-Ⅲstage patients, found that the onset age, TNM stage,ER status has correlated with PFS. The size of tumor, number of lymph node metastasis, menopause status can also impact PFS, but not reached statistically significant. The drug treatment combined with local treatment group has a longer MSR than drug treatment group (28.5m vs 32.8m, respectively). The liver metastasis prior to local metastasis or other organs has a poor prognosis(the survival time after metastasis or local recurrence 29.2m vs 73.2m respectively.P=0.044)Conclusions:Breast cancer patients with liver metastasis have a poor prognosis. The systemic treatment combined with local treatment is a Promising Strategy for the candidate patients, which may get a better survival.更多还原