北京最好治疗白癜风 http://wapyyk.39.net/bj/zhuanke/89ac7.html
年5月8日，施普林格·自然旗下《乳腺癌研究与治疗》在线发表韩国首尔高医院的研究报告，通过韩国医疗保险审核评定机构数据库，对早期乳腺癌患者接受蒽环类化疗和（或）曲妥珠单抗治疗所致充血性心力衰竭的发生率、发生时间和风险因素进行了大数据分析。
该研究从韩国医疗保险审查评定机构数据库列入年1月～年10月被诊断为早期乳腺癌、既往无充血性心力衰竭史、年龄19岁女性患者8万例。
结果发现充血性心力衰竭发生率：
蒽环类→曲妥珠单抗：6.3%
非蒽环类→曲妥珠单抗：4.2%
蒽环类化疗：3.1%
术后辅助治疗至充血性心力衰竭发生的中位时间：
蒽环类化疗：大约2年（.0天）
蒽环类→曲妥珠单抗：大约1年（.5天）
曲妥珠单抗治疗与充血性心力衰竭较早发生相关，无论之前化疗是否蒽环类，但是两个化疗组→曲妥珠单抗治疗后1.2年，充血性心力衰竭的远期风险迅速减少。
根据多因素比例风险回归分析，卡尔森合并症指数评分≥2的老年患者组（≥65岁）接受蒽环类→曲妥珠单抗后，充血性心力衰竭校正后风险比显著增加。
因此，该研究表明，对于韩国早期乳腺癌患者，无论之前化疗是否蒽环类，新辅助或辅助化疗→曲妥珠单抗与蒽环类化疗相比，充血性心力衰竭风险显著增加。
BreastCancerResTreat.May8.[Epubaheadofprint]
Incidenceandriskfactorsforcongestiveheartfailureinpatientswithearlybreastcancerwhoreceivedanthracyclineand/ortrastuzumab:abigdataanalysisoftheKoreanHealthInsuranceReviewandAssessmentservicedatabase.
JungYoonChoi,EunYoungCho,YoonJiChoi,JeongHyeonLee,SeungPilJung,KyuRanCho,ChulYongKim,YeulHongKim,KyongHwaPark.
KoreaUniversityAnamHospital,KoreaUniversityCollegeofMedicine,Seoul,Korea.
PURPOSE:Weaimedtoanalyzetheincidence,timetooccurrence,andcongestiveheartfailure(CHF)riskfactorsforearlybreastcancerpatientstreatedwithanthracycline(AC)-basedchemotherapyand/ortrastuzumab(T)therapyinKorea.
METHODS:Weincludedfemalepatients19yearsoldfromtheHealthInsuranceReviewandAssessmentServicedatabasewhohadnopriorCHFhistoryandhadbeendiagnosedwithearlybreastcancerbetweenJanuaryandOctober.
RESULTS:Weincluded83,patientsinouranalysis.IntermsofcrudeincidenceforCHF,ACfollowedbyTshowedthehighestincidence(6.3%).However,3.1and4.2%ofthepatientshadCHFduetoAC-basedchemotherapyandnon-ACfollowedbyT,respectively.ThemediantimestooccurrenceofCHFweredifferentaccordingtoadjuvanttreatments,approximately2years(.0days)intheAC-basedchemotherapygroupvs1year(.5days)ACfollowedbyTgroup.TtherapywasassociatedwithearlierdevelopmentofCHFirrespectiveofpreviouschemotherapy,butlateriskofCHF1.2yearsafterTtherapyrapidlydecreasedinbothchemotherapygroups.MultivariateCoxregressionanalysisrevealedthattheadjustedhazardratioforCHFwasincreasedinthegroupofolderpatients(≥65yearsold)whounderwentACfollowedbyTtherapy,withCharlson
