PDF(Pubmed)
Abstract：
BACKGROUND: The association between chemotherapy-induced leukopenia (CIL) and survival for patients with early breast cancer (EBC) is not known. We investigated the relationship between different grades of CIL and survival in patients with EBC receiving adjuvant chemotherapy.
METHODS: A total of 442 patients with EBC receiving a regimen containing an anthracycline (A) and taxane (T) were included into our analysis. Survival analyses were undertaken using Kaplan-Meier curves. The P-value was calculated using the log rank test. Subgroup analysis was conducted to investigate the correlation of CIL grade and survival based on the clinicopathological characteristics of patients. Afterwards, univariate and multivariate analyses screened out independent prognostic factors to construct a prognostic model, the robustness of which was verified.
RESULTS: Patients with EBC who experienced grade 2-4 (\"moderate\" and \"severe\") CIL were associated with longer overall survival (OS) than those with grade 0-1 (mild) CIL (P = 0.021). Compared with patients with mild CIL, OS was longer in patients with severe CIL (P = 0.029). Patients who suffered from moderate CIL tended to have longer OS than those with mild CIL (P = 0.082). Nevertheless, there was no distinguishable difference in OS between moderate- or severe-CIL groups. Subgroup analysis revealed that patients with moderate CIL had longer OS than those with mild CIL among patients who were premenstrual, or with human epidermal growth factor receptor 2-positive (HER2+), > 3 lymph nodes with metastases, a tumor diameter > 5 cm. A prognostic model based on menstrual status, N stage, and CIL grade showed satisfactory robustness.
CONCLUSIONS: The grade of CIL was strongly associated with the prognosis among patients with EBC who received a regimen containing both anthracyclines and taxanes. Patients with a \"moderate\" CIL grade tended to have better survival outcomes.
METHODS: A total of 442 patients with EBC receiving a regimen containing an anthracycline (A) and taxane (T) were included into our analysis. Survival analyses were undertaken using Kaplan-Meier curves. The P-value was calculated using the log rank test. Subgroup analysis was conducted to investigate the correlation of CIL grade and survival based on the clinicopathological characteristics of patients. Afterwards, univariate and multivariate analyses screened out independent prognostic factors to construct a prognostic model, the robustness of which was verified.
RESULTS: Patients with EBC who experienced grade 2-4 (\"moderate\" and \"severe\") CIL were associated with longer overall survival (OS) than those with grade 0-1 (mild) CIL (P = 0.021). Compared with patients with mild CIL, OS was longer in patients with severe CIL (P = 0.029). Patients who suffered from moderate CIL tended to have longer OS than those with mild CIL (P = 0.082). Nevertheless, there was no distinguishable difference in OS between moderate- or severe-CIL groups. Subgroup analysis revealed that patients with moderate CIL had longer OS than those with mild CIL among patients who were premenstrual, or with human epidermal growth factor receptor 2-positive (HER2+), > 3 lymph nodes with metastases, a tumor diameter > 5 cm. A prognostic model based on menstrual status, N stage, and CIL grade showed satisfactory robustness.
CONCLUSIONS: The grade of CIL was strongly associated with the prognosis among patients with EBC who received a regimen containing both anthracyclines and taxanes. Patients with a \"moderate\" CIL grade tended to have better survival outcomes.
摘要：
背景：化疗诱导的白细胞减少症（CIL）与早期乳腺癌（EBC）患者生存率之间的关系尚不清楚。我们调查了接受辅助化疗的EBC患者的不同CIL等级与生存率之间的关系。
方法：共有442例接受蒽环类（A）和紫杉烷（T）治疗方案的EBC患者纳入我们的分析。使用Kaplan-Meier曲线进行生存分析。使用对数秩检验计算P值。根据患者临床病理特征进行亚组分析，探讨CIL分级与生存的相关性。之后,单因素和多因素分析筛选出独立的预后因素来构建预后模型，其鲁棒性得到了验证。
结果：经历2-4级（“中度”和“重度”）CIL的EBC患者与0-1级（轻度）CIL患者的总生存期（OS）更长（P=0.021）。与mildCIL患者相比，重度CIL患者的OS更长（P=0.029）。患有中度CIL的患者比患有轻度CIL的患者具有更长的OS（P=0.082）。然而，中度或重度CIL组之间的OS无明显差异.亚组分析显示，在经前患者中，中度CIL患者的OS长于轻度CIL患者，或人类表皮生长因子受体2阳性（HER2+），>3淋巴结转移，肿瘤直径>5厘米。基于月经状态的预后模型，N级,和CIL等级显示出令人满意的稳健性。
结论：在接受蒽环类和紫杉烷类治疗方案的EBC患者中，CIL的分级与预后密切相关。具有“中度”CIL等级的患者往往具有更好的生存结果。
方法：共有442例接受蒽环类（A）和紫杉烷（T）治疗方案的EBC患者纳入我们的分析。使用Kaplan-Meier曲线进行生存分析。使用对数秩检验计算P值。根据患者临床病理特征进行亚组分析，探讨CIL分级与生存的相关性。之后,单因素和多因素分析筛选出独立的预后因素来构建预后模型，其鲁棒性得到了验证。
结果：经历2-4级（“中度”和“重度”）CIL的EBC患者与0-1级（轻度）CIL患者的总生存期（OS）更长（P=0.021）。与mildCIL患者相比，重度CIL患者的OS更长（P=0.029）。患有中度CIL的患者比患有轻度CIL的患者具有更长的OS（P=0.082）。然而，中度或重度CIL组之间的OS无明显差异.亚组分析显示，在经前患者中，中度CIL患者的OS长于轻度CIL患者，或人类表皮生长因子受体2阳性（HER2+），>3淋巴结转移，肿瘤直径>5厘米。基于月经状态的预后模型，N级,和CIL等级显示出令人满意的稳健性。
结论：在接受蒽环类和紫杉烷类治疗方案的EBC患者中，CIL的分级与预后密切相关。具有“中度”CIL等级的患者往往具有更好的生存结果。
