title: [Prognostic factors and analyses of different therapeutic strategies in HR+ breast cancer patients with bone-only metastases].
abstract: OBJECTIVE
  To explore the therapeutic outcomes of various first-line regimens and prognostic factors for hormone receptor positive (HR+) breast cancer (BrCa) patients with bone-only metastases.
  
  
  METHODS
  A total of 139 HR+ BrCa patients with bone-only metastases between January 1, 2005 and October 31, 2010 were retrospectively reviewed. Their clinicopathologic characteristics, various treatment regimens and clinical survival factors were analyzed. Furthermore, the effects of various therapeutic regimens on skeletal-related events (SREs) were explored.
  
  
  RESULTS
  In this cohort, 99 patients received first-line chemotherapeutic regimens and 40 had first-line endocrine drugs. Their median overall survival time was 61 months. No significant difference was noted in 5-year overall survival rate between first-line chemotherapy group (49.4%) and first-line endocrine group (44.3%) (hazard ratio (HR) 0.687, 95% confidence interval (CI) 0.307 - 1.539, P = 0.362). Furthermore, interval of disease-free survival > 3 years and number of positive lymph nodes < 10 were favorable prognostic factors by univariate analyses (HR = 0.333, 95%CI 0.138 - 0.803, P = 0.014; HR = 0.239, 95%CI 0.102 - 0.562, P = 0.001); they were also independent favorable prognostic factors by multivariate Cox-regression analyses. The proportion of patients with SREs decreased in the first-line chemotherapy group compared with the first-line endocrine group (45/99 (45.4%) vs 25/40 (62.5%)). Nonetheless, the difference was insignificant (P = 0.092).
  
  
  CONCLUSIONS
  Interval of disease-free survival > 3 years and number of positive lymph nodes < 10 are independent favorable prognostic factors. The overall survival of HR+ BrCa patients with bone-only metastases is not significantly different between two groups. First-line chemotherapy may lower the incidence of SREs. Both endocrine therapy and chemotherapy are effective for HR+ BrCa patients with bone-only metastases and they should be individualized.
authors: Cancer Hospital & Institute, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors: Xiao-yan
authors: XY
authors: Ding
authors: Ying
authors: Y
authors: Fan
authors: Fei
authors: F
authors: Ma
authors: Qing
authors: Q
authors: Li
authors: Jia-yu
authors: JY
authors: Wang
authors: Peng
authors: P
authors: Yuan
authors: Pin
authors: P
authors: Zhang
authors: Bing-he
authors: BH
authors: Xu
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D011987:Receptors, Steroid / Q000378:metabolism; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D011987:Receptors, Steroid