Prognostic factors for survival of women with unstable spinal bone metastases from breast cancer

Radiation Oncology

Harald Rief¹  Juergen Debus¹  Ingmar Schlampp¹  Tilman Bostel¹  Thomas Bruckner²  Robert Foerster¹ 

[1] Department of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, Heidelberg, 69120, Germany;Department of Medical Biometry, University Hospital Heidelberg, Im Neuenheimer Feld 305, Heidelberg, 69120, Germany

关键词: Stability;    Survival;    Radiotherapy;    Breast cancer;    Bone metastases;   

Others  :  1228501
DOI  :  10.1186/s13014-015-0458-9

 received in 2015-06-07, accepted in 2015-07-07,  发布年份 2015

【 摘 要 】

Background

Bone metastases are an important clinical issue in women with breast cancer. Particularly, unstable spinal bone metastases (SBM) are a major cause of severe morbidity and reduced quality of life (QoL) due to frequent immobilization. Radiotherapy (RT) is the major treatment modality and is capable of promoting re-ossification and improving stability. Since local therapy response is excellent, survival of these patients with unstable SBM is of high clinical importance. We therefore conducted this analysis to assess survival and to determine prognostic factors for bone survival (BS) in women with breast cancer and unstable SBM.

Methods

A total population of 92 women with unstable SBM from breast cancer who were treated with RT at our department between January 2000 and January 2012 was retrospectively investigated. We calculated overall survival (OS) and BS (time between first diagnosis of bone metastases until death) with the Kaplan-Meier method and assessed prognostic factors for BS with a Cox regression model.

Results

Mean age at first diagnosis of breast cancer was 60.8 years ± SD 12.4 years. OS after 1, 2 and 5 years was 84.8, 66.3 and 50 %, respectively. BS after 1, 2 and 5 years was 62.0, 33.7 and 12 %, respectively. An age > 50 years (p < .001; HR 1.036 [CI 1.015–1.057]), the presence of a single bone metastasis (p = .002; HR 0.469 [CI 0.292–0.753]) and triple negative phenotype (p < .001; HR 1.068 [CI 0.933–1.125]) were identified as independent prognostic factors for BS.

Conclusions

Our analysis demonstrated a short survival of women with breast cancer and unstable SBM. Age, presence of a solitary SBM and triple-negative phenotype correlated with survival. Our results may have an impact on therapeutic decisions in the future and offer a rationale for future prospective investigations.

【 授权许可】

   
2015 Foerster et al.

【 图 表 】

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