Advances in optical coherence tomography(OCT)technology allow a clear view of the vitreoretinal interface(VRI).The abnormality of the VRI is one of the common symptoms of high myopia,mainly including posterior vitreou...Advances in optical coherence tomography(OCT)technology allow a clear view of the vitreoretinal interface(VRI).The abnormality of the VRI is one of the common symptoms of high myopia,mainly including posterior vitreous detachment(PVD)and epiretinal membrane(ERM).They can cause severe damage to the structure and function of the retina,leading to permanent vision loss.Therefore,fully automated detection of abnormalities at the VRI is crucial for the management of high myopia.This paper presents a DS-YOLOv7 network aimed at accurately identifying abnormalities,including partial PVD,complete PVD,and ERM from retinal OCT images.Built upon the YOLOv7 network,the proposed model integrates the advanced dynamic snake convolution(DSConv)module to capture the curvilinear characteristics of lesions,and the mixture of attention and convolution(ACMix)module to improve the precision and robustness of feature extraction through effective fusion of self-attention mechanisms and convolution.Moreover,the introduction of the efficient complete intersection-over-union(ECIoU)loss function further enhances the coordinate regression capability of the model.Threefold cross-validation on a dataset with 1973 OCT B-scans from 46 patients shows that the DS-YOLOv7 achieved superior performance in vitreoretinal interface abnormality detection,with mAP@0.5 of 0.714,mAP@0.75 of 0.438,and mAP@0.5:0.95 of 0.424.The proposed model can provide an accurate and efficient diagnostic tool for patients with high myopia.展开更多
To analyze the effects of a time-varying viscosity on the penetration length of grouting,in this study cement slur-ries with varying water-cement ratios have been investigated using the Bingham’sfluidflow equation and ...To analyze the effects of a time-varying viscosity on the penetration length of grouting,in this study cement slur-ries with varying water-cement ratios have been investigated using the Bingham’sfluidflow equation and a dis-crete element method.Afluid-solid coupling numerical model has been introduced accordingly,and its accuracy has been validated through comparison of theoretical and numerical solutions.For different fracture forms(a single fracture,a branch fracture,and a fracture network),the influence of the time-varying viscosity on the slurry length range has been investigated,considering the change in the fracture aperture.The results show that under different fracture forms and the same grouting process conditions,the influence of the time-varying viscosity on the seepage length is 0.350 m.展开更多
Objective:A subset of patients with human epidermal growth factor receptor 2 positive(HER2+)breast cancer shows insensitivity to neoadjuvant therapy(NAT),often evidenced by imaging results indicating stable disease(SD...Objective:A subset of patients with human epidermal growth factor receptor 2 positive(HER2+)breast cancer shows insensitivity to neoadjuvant therapy(NAT),often evidenced by imaging results indicating stable disease(SD)or progressive disease(PD),which may reflect intrinsic resistance to treatment.We aimed to investigate the factors associated with NAT insensitivity and its prognostic value in HER2+breast cancer.Methods:This study included consecutive patients with HER2+breast cancer who received NAT consisting of chemotherapy combined with anti-HER2 monoclonal antibodies.NAT insensitivity was defined as SD or PD on the basis of treatment response evaluations.Statistical analyses were conducted on the collected clinical data,and HER2 heterogeneity was subsequently assessed.Results:A total of 541 patients were included in the study,among whom 63(11.6%)were categorized as NATinsensitive group and 478(88.4%)as NAT-sensitive group.Hormone receptor(HR)status(P=0.033),HER2 status(P=0.036)and anti-HER2 therapy(P=0.007)were associated with NAT sensitivity.NAT-insensitive group had a significantly shorter event-free survival(EFS)(3-year:69.4%vs.94.3%;P<0.001)and remained an independent prognostic factor according to Cox models[hazard ratio(HR)=8.637;95%confidence interval(95%CI),3.091-24.136;P<0.001].Exploratory analysis revealed a greater proportion of HER2 heterogeneity in the NAT-insensitive group(19.4%vs.4.3%;P=0.035).Conclusions:HR positivity,HER22+/fluorescence in situ hybridization(FISH)+status,and trastuzumab monotherapy are associated with NAT insensitivity,and NAT insensitivity independently indicates poor EFS.This study also highlights the need for prospective studies to clarify the role of HER2 heterogeneity and other mechanisms involved in predicting the response to NAT.展开更多
The unique structure of signed networks,characterized by positive and negative edges,poses significant challenges for analyzing network topology.In recent years,various statistical algorithms have been developed to ad...The unique structure of signed networks,characterized by positive and negative edges,poses significant challenges for analyzing network topology.In recent years,various statistical algorithms have been developed to address this issue.However,there remains a lack of a unified framework to uncover the nontrivial properties inherent in signed network structures.To support developers,researchers,and practitioners in this field,we introduce a Python library named SNSAlib(Signed Network Structure Analysis),specifically designed to meet these analytical requirements.This library encompasses empirical signed network datasets,signed null model algorithms,signed statistics algorithms,and evaluation indicators.The primary objective of SNSAlib is to facilitate the systematic analysis of micro-and meso-structure features within signed networks,including node popularity,clustering,assortativity,embeddedness,and community structure by employing more accurate signed null models.Ultimately,it provides a robust paradigm for structure analysis of signed networks that enhances our understanding and application of signed networks.展开更多
The Kuramoto model is one of the most profound and classical models of coupled phase oscillators.Because of the global couplings between oscillators,its precise critical exponents can be obtained using the mean-field ...The Kuramoto model is one of the most profound and classical models of coupled phase oscillators.Because of the global couplings between oscillators,its precise critical exponents can be obtained using the mean-field approximation(MFA),where the time average of the modulus of the mean-field is defined as the order parameter.Here,we further study the phase fluctuations of oscillators from the mean-field using the eigen microstate theory(EMT),which was recently developed.The synchronization of phase fluctuations is identified by the condensation and criticality of eigen microstates with finite eigenvalues,which follow the finite-size scaling with the same critical exponents as those of the MFA in the critical regime.Then,we obtain the complete critical behaviors of phase oscillators in the Kuramoto model.We anticipate that the critical behaviors of general phase oscillators can be investigated by using the EMT and different critical exponents from those of the MFA will be obtained.展开更多
Objective: To assess the long-term effectiveness and safety of trastuzumab in adjuvant therapy for Chinese patients with early-stage human epidermal growth factor 2(HER2)-positive breast cancer in a real-world setting...Objective: To assess the long-term effectiveness and safety of trastuzumab in adjuvant therapy for Chinese patients with early-stage human epidermal growth factor 2(HER2)-positive breast cancer in a real-world setting.Methods: This retrospective observational study analyzed the medical records of HER2-positive breast cancer patients between 2000 and 2012 at the Chinese Academy of Medical Sciences. Patients who received adjuvant chemotherapy alone or adjuvant chemotherapy followed by/combined with trastuzumab were included. The Kaplan-Meier method was used to estimate disease-free survival(DFS) and overall survival(OS). Hazard ratios(HR) and 95% confidence intervals(95% CI) were calculated using the Cox regression model.Results: Of the 1,348 patients analyzed, 909 received chemotherapy alone and 439 received chemotherapy plus trastuzumab. The 3-year, 5-year and 10-year DFS rates were 83.70%, 76.38% and 68.94%, respectively, in the chemotherapy-alone cohort, and 90.21%, 86.19% and 83.45% in the chemotherapy plus trastuzumab cohort. The3-year, 5-year and 10-year OS rates were 96.10%, 91.40% and 81.88% in the chemotherapy-alone cohort, and98.17%, 94.91% and 90.01% in the chemotherapy plus trastuzumab cohort. The chemotherapy plus trastuzumab group had a significantly lower risk of disease recurrence and death than the chemotherapy-alone group(DFS:HR=0.50, 95% CI, 0.37-0.68;P<0.001;OS: HR=0.53, 95% CI, 0.34-0.81;P=0.004) after adjusting for covariates.In the 439 patients treated with trastuzumab, multivariate analysis suggested that lymph node positivity, higher T stages, and hormone receptor-negative status were significantly associated with higher risks of disease recurrence,and lymph node positivity and hormone receptor-negative status were significantly associated with higher risks of death. Grade 3/4 adverse events(incidence ≥1%) were more common in patients receiving trastuzumab(54.44% vs.15.73%).Conclusions: Early-stage HER2-positive breast cancer patients treated with trastuzumab plus adjuvant chemotherapy have a significant survival benefit compared with chemotherapy-alone in real-world settings. Lymph node positivity, hormone receptor-negative status, and higher T stages may be associated with higher risks of recurrence, and effective therapy for patients with these factors is required.展开更多
Background There is a paucity of data about the best lipid ratio predicting the severity of coronary artery disease （CAD） in patients with diabetes mellitus. We determined the relationship between five conventional ...Background There is a paucity of data about the best lipid ratio predicting the severity of coronary artery disease （CAD） in patients with diabetes mellitus. We determined the relationship between five conventional lipid ratios and the extent of coronary artery lesions in Chinese Type 2 diabetics with stable angina pectoris （SAP）. Methods A prospective cohort study within 373 type 2 diabetic patients diag- nosed with stable CAD by coronary angiography was performed. All patients were classified into three groups according to the tertiles of Gensini scores （GS, low group 〈 8 points n = 143; intermediate group 8-28 points, n = 109; high group 〉 28 points, n = 121）. Association between the ratios of apolipoprotein （apo） B and apoA-1, total cholesterol and high density lipoprotein cholesterol （TC/HDL-C）, triglycerides and HDL-C （TG/HDL-C）, low density lipoprotein cholesterol and HDL-C （LDL-C/HDL-C）, Non-HDL-C/HDL-C and GS were evaluated using the receivers operating characteristic （ROC） curves and multivariate logistic regression models. Results The ratio of apoB/apoA-1, TC/HDL-C, LDL-C/HDL-C, and Non-HDL-C/HDL-C were correlated with Gensini scores. Area under the ROC curves for predicting high Gensini scores in the ratios of apoB/apoA-1, TC/HDL-C, LDL-C/HDL-C and Non-HDL-C/HDL-C were 0.62, 0.60, 0.59 and 0.60, respec- tively （P 〈 0.005 for all）. According to multivariate logistic regression analysis after adjusted with demographic characteristic and other lipid parameters, the ratio of apoB/apoA-1 is qualified as an independent discriminator for the severity of CAD. However, after fiu-ther adjusting different baseline variables, such as left ventricular ejective fraction, hemoglobin Alc, leukocytes count and serum creatinine, none of the above lipid ratios remained. Conclusions Compared with other lipid parameters, the ratio of apoB/apoA-1 appears to be more significantly correlated with the extent of coronary artery lesions in Chinese diabetics, but it was not an independent predictor in these settings.展开更多
Background:Both hormonal therapy(HT) and maintenance capecitabine monotherapy(MCT) have been shown to extend time to progression(TTP) in patients with metastatic breast cancer(MBC) after failure of taxanes and anthrac...Background:Both hormonal therapy(HT) and maintenance capecitabine monotherapy(MCT) have been shown to extend time to progression(TTP) in patients with metastatic breast cancer(MBC) after failure of taxanes and anthracycline?containing regimens.However,no clinical trials have directly compared the efficacy of MCT and HT after response to first?line capecitabine?based combination chemotherapy(FCCT) in patients with hormone receptor(HR)?positive and human epidermal growth factor receptor 2(HER2)?negative breast cancer.Methods:We retrospectively analyzed the charts of 138 HR?positive and HER2?negative MBC patients who were in non?progression status after FCCT and who were treated between 2003 and 2012 at the Cancer Institute and Hospital,Chinese Academy of Medical Sciences,in Beijing,China.The median number of first?line chemotherapy cycles was 6(range,4–8);combined agents included taxanes,vinorelbine,or gemcitabine.Of these 138 patients,79 received MCT,and 59 received HT.Single?agent capecitabine was administered at a dose of 1250 mg/m2 twice daily for 14 days,followed by a 7?day rest period,repeated every 3 weeks.Of the 59 patients who received HT,37 received aromatase inhibitors(AIs),8 received selective estrogen receptor modulators(SERMs),and 14 received goserelin plus either AIs or SERMs.We then compared the MCT group and HT group in terms of treatment efficacy.Results:With a median follow?up of 43 months,patients in the HT group had a much longer TTP than patients in the MCT group(13 vs.8 months,P ease?free surviv= 0.011).When TTP was adjusted for age,menopausal status,Karnofsky performance status score,disal,site of metastasis,number of metastatic sites,and response status after FCCT,extended TTP was still observed for patients in the HT group(hazard ratio:0.63;95% confidence interval:0.44–0.93;P = 0.020).We also observed a trend of overall survival advantage for patients in the HT group vs.patients in the MCT group,but the difference was not significant(43 vs.37 months,P tients in the MCT g= 0.400).In addition,patients in the HT group gen?erally tolerated the treatment well,whereas paroup experienced grades 3–4 adverse events,the most frequent of which were hand?foot syndrome(15.8%) and hematologic abnormalities(7.6%).Conclusion:For HR?positive and HER2?negative MBC patients,HT might be considered a treatment after response to FCCT but prior to MCT as a long?term administration.展开更多
基金supported by the National Natural Science Foundation of China(62271337,62371326,and 62371328)the National Key Research and Development Program of China(2019FYC1710204)+1 种基金the National Clinical Key Specialty Construction Project(10000015Z155080000004)the Natural Science Foundation of Jiangsu Province(BK20231310).
文摘Advances in optical coherence tomography(OCT)technology allow a clear view of the vitreoretinal interface(VRI).The abnormality of the VRI is one of the common symptoms of high myopia,mainly including posterior vitreous detachment(PVD)and epiretinal membrane(ERM).They can cause severe damage to the structure and function of the retina,leading to permanent vision loss.Therefore,fully automated detection of abnormalities at the VRI is crucial for the management of high myopia.This paper presents a DS-YOLOv7 network aimed at accurately identifying abnormalities,including partial PVD,complete PVD,and ERM from retinal OCT images.Built upon the YOLOv7 network,the proposed model integrates the advanced dynamic snake convolution(DSConv)module to capture the curvilinear characteristics of lesions,and the mixture of attention and convolution(ACMix)module to improve the precision and robustness of feature extraction through effective fusion of self-attention mechanisms and convolution.Moreover,the introduction of the efficient complete intersection-over-union(ECIoU)loss function further enhances the coordinate regression capability of the model.Threefold cross-validation on a dataset with 1973 OCT B-scans from 46 patients shows that the DS-YOLOv7 achieved superior performance in vitreoretinal interface abnormality detection,with mAP@0.5 of 0.714,mAP@0.75 of 0.438,and mAP@0.5:0.95 of 0.424.The proposed model can provide an accurate and efficient diagnostic tool for patients with high myopia.
基金supported by the National Natural Science Foundation of China(Grant Numbers:U22A20234,42277170)the Key Research and Development Project of Hubei Province(Grant Number:2020BCB073).
文摘To analyze the effects of a time-varying viscosity on the penetration length of grouting,in this study cement slur-ries with varying water-cement ratios have been investigated using the Bingham’sfluidflow equation and a dis-crete element method.Afluid-solid coupling numerical model has been introduced accordingly,and its accuracy has been validated through comparison of theoretical and numerical solutions.For different fracture forms(a single fracture,a branch fracture,and a fracture network),the influence of the time-varying viscosity on the slurry length range has been investigated,considering the change in the fracture aperture.The results show that under different fracture forms and the same grouting process conditions,the influence of the time-varying viscosity on the seepage length is 0.350 m.
基金supported by the CAMS Innovation Fund for Medical Sciences(CIFMS,No.2021-I2M-1-014,2023-I2M-C&T-B-077 and 2023-I2M-C&T-B-081)the Beijing Natural Science Foundation(No.L258033)the National High Level Hospital Clinical Research Funding(No.2025-LYZX-D-A02)。
文摘Objective:A subset of patients with human epidermal growth factor receptor 2 positive(HER2+)breast cancer shows insensitivity to neoadjuvant therapy(NAT),often evidenced by imaging results indicating stable disease(SD)or progressive disease(PD),which may reflect intrinsic resistance to treatment.We aimed to investigate the factors associated with NAT insensitivity and its prognostic value in HER2+breast cancer.Methods:This study included consecutive patients with HER2+breast cancer who received NAT consisting of chemotherapy combined with anti-HER2 monoclonal antibodies.NAT insensitivity was defined as SD or PD on the basis of treatment response evaluations.Statistical analyses were conducted on the collected clinical data,and HER2 heterogeneity was subsequently assessed.Results:A total of 541 patients were included in the study,among whom 63(11.6%)were categorized as NATinsensitive group and 478(88.4%)as NAT-sensitive group.Hormone receptor(HR)status(P=0.033),HER2 status(P=0.036)and anti-HER2 therapy(P=0.007)were associated with NAT sensitivity.NAT-insensitive group had a significantly shorter event-free survival(EFS)(3-year:69.4%vs.94.3%;P<0.001)and remained an independent prognostic factor according to Cox models[hazard ratio(HR)=8.637;95%confidence interval(95%CI),3.091-24.136;P<0.001].Exploratory analysis revealed a greater proportion of HER2 heterogeneity in the NAT-insensitive group(19.4%vs.4.3%;P=0.035).Conclusions:HR positivity,HER22+/fluorescence in situ hybridization(FISH)+status,and trastuzumab monotherapy are associated with NAT insensitivity,and NAT insensitivity independently indicates poor EFS.This study also highlights the need for prospective studies to clarify the role of HER2 heterogeneity and other mechanisms involved in predicting the response to NAT.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.72371031,62173065,62476045)Fundamental Research Funds for the Central Universities(Grant No.124330008)。
文摘The unique structure of signed networks,characterized by positive and negative edges,poses significant challenges for analyzing network topology.In recent years,various statistical algorithms have been developed to address this issue.However,there remains a lack of a unified framework to uncover the nontrivial properties inherent in signed network structures.To support developers,researchers,and practitioners in this field,we introduce a Python library named SNSAlib(Signed Network Structure Analysis),specifically designed to meet these analytical requirements.This library encompasses empirical signed network datasets,signed null model algorithms,signed statistics algorithms,and evaluation indicators.The primary objective of SNSAlib is to facilitate the systematic analysis of micro-and meso-structure features within signed networks,including node popularity,clustering,assortativity,embeddedness,and community structure by employing more accurate signed null models.Ultimately,it provides a robust paradigm for structure analysis of signed networks that enhances our understanding and application of signed networks.
基金supported by the National Natural Science Foundation of China(Grant Nos.12135003,71731002,and 12471141)the Postdoctoral Fellowship Program of CPSF(Grant No.GZC20231179)+1 种基金the China Postdoctoral Science Foundation-Tianjin Joint Support Program(Grant No.2023T001TJ)the Tianjin Education Commission scientific Research Project(Grant No.2023SK070)。
文摘The Kuramoto model is one of the most profound and classical models of coupled phase oscillators.Because of the global couplings between oscillators,its precise critical exponents can be obtained using the mean-field approximation(MFA),where the time average of the modulus of the mean-field is defined as the order parameter.Here,we further study the phase fluctuations of oscillators from the mean-field using the eigen microstate theory(EMT),which was recently developed.The synchronization of phase fluctuations is identified by the condensation and criticality of eigen microstates with finite eigenvalues,which follow the finite-size scaling with the same critical exponents as those of the MFA in the critical regime.Then,we obtain the complete critical behaviors of phase oscillators in the Kuramoto model.We anticipate that the critical behaviors of general phase oscillators can be investigated by using the EMT and different critical exponents from those of the MFA will be obtained.
基金supported by the Chinese Academic of Medical Sciences Initiative for Innovative Medicine (No. CAMS-I2M-1-010)
文摘Objective: To assess the long-term effectiveness and safety of trastuzumab in adjuvant therapy for Chinese patients with early-stage human epidermal growth factor 2(HER2)-positive breast cancer in a real-world setting.Methods: This retrospective observational study analyzed the medical records of HER2-positive breast cancer patients between 2000 and 2012 at the Chinese Academy of Medical Sciences. Patients who received adjuvant chemotherapy alone or adjuvant chemotherapy followed by/combined with trastuzumab were included. The Kaplan-Meier method was used to estimate disease-free survival(DFS) and overall survival(OS). Hazard ratios(HR) and 95% confidence intervals(95% CI) were calculated using the Cox regression model.Results: Of the 1,348 patients analyzed, 909 received chemotherapy alone and 439 received chemotherapy plus trastuzumab. The 3-year, 5-year and 10-year DFS rates were 83.70%, 76.38% and 68.94%, respectively, in the chemotherapy-alone cohort, and 90.21%, 86.19% and 83.45% in the chemotherapy plus trastuzumab cohort. The3-year, 5-year and 10-year OS rates were 96.10%, 91.40% and 81.88% in the chemotherapy-alone cohort, and98.17%, 94.91% and 90.01% in the chemotherapy plus trastuzumab cohort. The chemotherapy plus trastuzumab group had a significantly lower risk of disease recurrence and death than the chemotherapy-alone group(DFS:HR=0.50, 95% CI, 0.37-0.68;P<0.001;OS: HR=0.53, 95% CI, 0.34-0.81;P=0.004) after adjusting for covariates.In the 439 patients treated with trastuzumab, multivariate analysis suggested that lymph node positivity, higher T stages, and hormone receptor-negative status were significantly associated with higher risks of disease recurrence,and lymph node positivity and hormone receptor-negative status were significantly associated with higher risks of death. Grade 3/4 adverse events(incidence ≥1%) were more common in patients receiving trastuzumab(54.44% vs.15.73%).Conclusions: Early-stage HER2-positive breast cancer patients treated with trastuzumab plus adjuvant chemotherapy have a significant survival benefit compared with chemotherapy-alone in real-world settings. Lymph node positivity, hormone receptor-negative status, and higher T stages may be associated with higher risks of recurrence, and effective therapy for patients with these factors is required.
文摘Background There is a paucity of data about the best lipid ratio predicting the severity of coronary artery disease （CAD） in patients with diabetes mellitus. We determined the relationship between five conventional lipid ratios and the extent of coronary artery lesions in Chinese Type 2 diabetics with stable angina pectoris （SAP）. Methods A prospective cohort study within 373 type 2 diabetic patients diag- nosed with stable CAD by coronary angiography was performed. All patients were classified into three groups according to the tertiles of Gensini scores （GS, low group 〈 8 points n = 143; intermediate group 8-28 points, n = 109; high group 〉 28 points, n = 121）. Association between the ratios of apolipoprotein （apo） B and apoA-1, total cholesterol and high density lipoprotein cholesterol （TC/HDL-C）, triglycerides and HDL-C （TG/HDL-C）, low density lipoprotein cholesterol and HDL-C （LDL-C/HDL-C）, Non-HDL-C/HDL-C and GS were evaluated using the receivers operating characteristic （ROC） curves and multivariate logistic regression models. Results The ratio of apoB/apoA-1, TC/HDL-C, LDL-C/HDL-C, and Non-HDL-C/HDL-C were correlated with Gensini scores. Area under the ROC curves for predicting high Gensini scores in the ratios of apoB/apoA-1, TC/HDL-C, LDL-C/HDL-C and Non-HDL-C/HDL-C were 0.62, 0.60, 0.59 and 0.60, respec- tively （P 〈 0.005 for all）. According to multivariate logistic regression analysis after adjusted with demographic characteristic and other lipid parameters, the ratio of apoB/apoA-1 is qualified as an independent discriminator for the severity of CAD. However, after fiu-ther adjusting different baseline variables, such as left ventricular ejective fraction, hemoglobin Alc, leukocytes count and serum creatinine, none of the above lipid ratios remained. Conclusions Compared with other lipid parameters, the ratio of apoB/apoA-1 appears to be more significantly correlated with the extent of coronary artery lesions in Chinese diabetics, but it was not an independent predictor in these settings.
基金This work was sup-ported by National Natural Sclence Foundatlon of China(no.81202108)
文摘Background:Both hormonal therapy(HT) and maintenance capecitabine monotherapy(MCT) have been shown to extend time to progression(TTP) in patients with metastatic breast cancer(MBC) after failure of taxanes and anthracycline?containing regimens.However,no clinical trials have directly compared the efficacy of MCT and HT after response to first?line capecitabine?based combination chemotherapy(FCCT) in patients with hormone receptor(HR)?positive and human epidermal growth factor receptor 2(HER2)?negative breast cancer.Methods:We retrospectively analyzed the charts of 138 HR?positive and HER2?negative MBC patients who were in non?progression status after FCCT and who were treated between 2003 and 2012 at the Cancer Institute and Hospital,Chinese Academy of Medical Sciences,in Beijing,China.The median number of first?line chemotherapy cycles was 6(range,4–8);combined agents included taxanes,vinorelbine,or gemcitabine.Of these 138 patients,79 received MCT,and 59 received HT.Single?agent capecitabine was administered at a dose of 1250 mg/m2 twice daily for 14 days,followed by a 7?day rest period,repeated every 3 weeks.Of the 59 patients who received HT,37 received aromatase inhibitors(AIs),8 received selective estrogen receptor modulators(SERMs),and 14 received goserelin plus either AIs or SERMs.We then compared the MCT group and HT group in terms of treatment efficacy.Results:With a median follow?up of 43 months,patients in the HT group had a much longer TTP than patients in the MCT group(13 vs.8 months,P ease?free surviv= 0.011).When TTP was adjusted for age,menopausal status,Karnofsky performance status score,disal,site of metastasis,number of metastatic sites,and response status after FCCT,extended TTP was still observed for patients in the HT group(hazard ratio:0.63;95% confidence interval:0.44–0.93;P = 0.020).We also observed a trend of overall survival advantage for patients in the HT group vs.patients in the MCT group,but the difference was not significant(43 vs.37 months,P tients in the MCT g= 0.400).In addition,patients in the HT group gen?erally tolerated the treatment well,whereas paroup experienced grades 3–4 adverse events,the most frequent of which were hand?foot syndrome(15.8%) and hematologic abnormalities(7.6%).Conclusion:For HR?positive and HER2?negative MBC patients,HT might be considered a treatment after response to FCCT but prior to MCT as a long?term administration.
