Development of a Prognostic Score in Patients With Advanced Breast Cancer Treated for Meningeal Carcinomatosis

IF 1.9 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Breast Journal Pub Date : 2025-03-07 DOI:10.1155/tbj/5438600

Grégoire Narjoux, Juliette Mainguené, Marie-Noëlle Guilhaume, Olivier Brenet, Edith Borcoman, Laurence Escalup, Hélène Salaun, Pauline Moreau, Anne-Sophie Bouyer, Paul Cottu

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引用次数: 0

Abstract

Purpose: Meningeal carcinomatosis (MC) has a dismal prognosis in patients with breast cancer and requires invasive therapies. The aim of the present retrospective study was to determine a prognostic score for overall survival (OS) in patients with breast cancer and treated for MC.

Methods: The data of 109 patients with proven breast cancer MC treated with at least one intrathecal (IT) injection of methotrexate or thiotepa at Institut Curie were retrospectively recorded from 2011 to 2019. We developed prognostic clinical scores for OS and 24-week survival.

Results: The diagnosis and evaluation of MC were based on a combination of clinical, imaging, and laboratory studies. Three significant prognostic factors for OS were identified. Clinical response or stabilization after one month of IT therapy had a favorable independent prognostic value for both OS and 24-week survival. Additionally, a baseline CSF Cyfra 21-1 concentration lower than 79 ng/mL in the cerebrospinal fluid (CSF) and the absence of 1-month CSF malignant cells had borderline favorable independent prognostic value for OS and 24-week survival, respectively. We constructed 2-class and 3-class prognostic scores for each outcome, identifying a population with a very poor prognosis.

Conclusions: To our knowledge, this is the first study to develop a response-based prognosis score for patients with breast cancer-related MC. This one-month prognostic score may help to determine which patient could actually benefit from prolonged IT therapy.

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晚期乳腺癌脑膜癌患者预后评分的发展

目的：乳腺癌患者脑膜癌（MC）预后差，需要侵入性治疗。本回顾性研究的目的是确定乳腺癌并接受MC治疗的患者的总生存期（OS）的预后评分。方法：回顾性记录2011年至2019年居里研究所109例经证实的乳腺癌MC患者的数据，这些患者接受了至少一次甲氨蝶呤或硫替帕鞘内注射。我们制定了OS和24周生存期的预后临床评分。结果：MC的诊断和评估是基于临床、影像学和实验室研究的结合。确定了OS的三个重要预后因素。IT治疗一个月后的临床反应或稳定对OS和24周生存均具有良好的独立预后价值。此外，脑脊液（CSF）中Cyfra 21-1的基线浓度低于79 ng/mL，以及1个月脑脊液中没有恶性细胞，分别对OS和24周生存具有边缘性有利的独立预后价值。我们为每个结果构建了2级和3级预后评分，以确定预后极差的人群。结论：据我们所知，这是第一个为乳腺癌相关MC患者开发基于反应的预后评分的研究。这个一个月的预后评分可能有助于确定哪些患者实际上可以从延长的IT治疗中受益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Journal 医学-妇产科学

CiteScore

4.00

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： The Breast Journal is the first comprehensive, multidisciplinary source devoted exclusively to all facets of research, diagnosis, and treatment of breast disease. The Breast Journal encompasses the latest news and technologies from the many medical specialties concerned with breast disease care in order to address the disease within the context of an integrated breast health care. This editorial philosophy recognizes the special social, sexual, and psychological considerations that distinguish cancer, and breast cancer in particular, from other serious diseases. Topics specifically within the scope of The Breast Journal include: Risk Factors Prevention Early Detection Diagnosis and Therapy Psychological Issues Quality of Life Biology of Breast Cancer.