JAMA Oncol :ER+/N+合并多种并发症的老年乳腺癌患者中,化疗与生存期的关系

2020-08-18 王水莲 肿瘤资讯

乳腺癌风险和并发症的发生率随着年龄增长而增加,老年且伴随明显并发症的患者治疗面临着挑战。努力为这些患者提供全面的治疗,最大程度地降低对生活质量的影响,并避免对预期寿命已经有限的患者的功能状态造成损害。

乳腺癌风险和并发症的发生率随着年龄的增长而增加,老年且伴随明显并发症的患者治疗面临着挑战。努力为这些患者提供全面的治疗,同时最大程度地降低对生活质量的影响,并避免对预期寿命已经有限的患者的功能状态造成损害至关重要。近日,JAMA Oncology发表了一项回顾性的研究,使用了美国国家癌症数据库(NCDB)的数据,研究在接受乳腺和腋窝手术的雌激素受体阳性,病理性淋巴结阳性的浸润性乳腺癌合并多种并发症的老年患者中,辅助化疗与生存期的关系,为老年乳腺癌合并多种并发症的患者治疗决策提供了新依据。

老年乳腺癌合并并发症患者辅助化疗的个性化探索

乳腺癌的风险和并发症随着年龄的增长而增加,在淋巴结阳性合并多种并发症的老年乳腺癌患者中,辅助化疗与生存率之间的关系缺乏数据。对4项针对淋巴结阳性的女性乳腺癌的随机临床试验的回顾性研究指出,年老或年轻的患者接受强烈的化疗方案可以使乳腺癌的死亡率和复发率均降低。但是在这项研究中,仅有2%的患者年龄>70岁,作者告诫不要将这些发现应用于老年患者。当前的NCCN老年患者乳腺癌指南指出:对于年龄>70岁的女性患者…...没有足够的数据提出明确的化疗建议…...对于该年龄段的患者,应考虑并发症,进行个体化治疗。

由于经常将患有多种合并症的老年患者从临床试验中排除,因此缺乏与辅助化疗相关的生存获益的数据。鉴于人口老龄化的增加以及老年乳腺癌患者缺乏标准化的治疗方法,研究这部分人群癌症的治疗与生存期的关系至关重要,这项研究的目的是研究在接受乳腺和腋窝手术的雌激素受体阳性,病理性淋巴结阳性的浸润性乳腺癌合并多发合并症的老年患者中,辅助化疗与生存期的关系。

这项回顾性队列研究使用了美国国家癌症数据库(NCDB)的数据,该数据库是美国外科医生学院和美国癌症学会的癌症委员会的联合项目,从2010年1月1日至2014年12月31日,从NCDB数据库筛选出年龄≥70岁,接受乳腺和腋窝手术,雌激素受体阳性和HER2阴性,分期为pT1-4/pN1-3浸润性乳腺癌患者,纳Charlson/Deyo并发症评分为2或3分的患者,排除Charlson/Deyo并发症评分为1或0分的患者。Charlson / Deyo评分是从并发症的分数总和中得出的加权分数。例如,得分为2的患者可能包括患有慢性肺部疾病和充血性心力衰竭。在当前这项研究中,得分为2或3的患者被认为患有严重的并发症,需要进行医疗管理,影响总体健康,并可能影响预期寿命。分析中包括了NCDB定义的种族/民族,以使结果更广泛地推广到美国人群。如果患者被诊断为M1期疾病,则将其排除在外。接受过新辅助疗法(化疗,放疗或内分泌治疗)的患者;接受除乳房肿块切除术和乳房切除术以外的乳房手术的患者,没有进行腋窝手术的患者,手术情况未知和辅助治疗数据缺失的患者均被排除。激素受体状态缺失和HER2阳性的患者被排除。数据分析:为了减少观察性研究数据治疗选择的偏倚对治疗和总生存期产生的影响,研究人员进行了倾向评分匹配分析,在匹配分析中,研究人员那将以下协变量包括在多元logistic回归模型中以创建倾向性评分:诊断时的年龄,Charlson / Deyo得分(2或3),机体状态,地理位置(大城市,城市,农村或未知),病理性T分期,病理性N分期,内分泌治疗和放疗。

ER+/N+合并多种并发症的老年乳腺癌患者,辅助化疗与OS改善相关

数据库中共有2445870名患者,1592名患者满足入组标准(平均年龄为77.5岁;1543 [96.9%]名女性)包含在最初的不匹配分析中。其中350例(22.0%)接受了化疗,1242例(78.0%)未接受化疗。与未接受化疗的患者相比,接受化疗的患者更加年轻(中位年龄为74岁,对比年龄为78岁),更高的疾病分级(3级: 116 [33.1%] vs 302[24.3%]; P = 0.002),较大的原发肿瘤(肿瘤分期为pT3/T4 : 72 [20.6%]化疗组对比182 [14.7%]非化疗组,P = 0.005),较高的淋巴结负荷(肿瘤分期pN3在化疗组为75 [21.4%] 对比 非化疗组81 [6.5%] ,肿瘤分期pN1化疗组为182 [52.0%] 对比非化疗组936 [75.4%])。与未接受化疗的患者相比,接受化疗的患者中更多的接受了放疗(236[67.4%] 对比 540 [43.5%]; P < 0.001)和内分泌治疗(309[88.3%] 对比 1025 [82.5%]; P = 0.01),在化疗和未化疗的患者之间,进行初次乳房手术类型(肿块切除术或乳房切除术)没有差异,两组中的大多数患者都进行了乳房切除术。

OS结果:在非匹配队列中,中位随访41.4个月(95%CI,39.7-43.7个月),整个小组的中位OS为59.5个月(95%CI,55.0-65.6个月):接受化疗的患者OS为78.9个月(95%CI,68.2个月至未达到)和未接受化疗的患者OS为54.9个月(95%CI,51.3-58.0个月)。

倾向评分匹配分析和结果:在匹配性分析中共包含592个患者,在两组之间所有可变量的绝对标准差小于10.25%,(表1)代表了匹配性较好,在匹配队列中,中位随访43.1个月(95%CI:39.6至46.5个月);化疗组中位OS为78.9个月(95%CI,78.9个月至未达到);非化疗组中位OS为62.7个月(95%CI,56.2个月至未达到),两者之间差异无统计学意义(P=0.13)。

多因素分析:在匹配队列中调整了其他危险因素后与非化疗组相比,化疗组存在OS获益,风险比HR=0.67;(95% CI,0.48-0.93; P=0.02),在匹配队列中与较差预后显着相关的因素为Charlson/Deyo 评分 3分对比2分 (HR, 1.94; 95% CI,1.34-2.79; P<0.001),较高的病理T分期 (pT4 vs pT1: HR, 3.51; 95% CI, 1.86-6.62; P<0.001),较高的病理N分期(pN3 vs pN1:HR, 1.71; 95% CI, 1.09-2.69; P =0.04)。在匹配队列中与OS预后改善相关的因素为接受内分泌治疗(HR,0.47; 95% CI,0.31-0.72; P<0.001),接受放疗(HR,0.61; 95% CI,0.43-0.87; P=0.006)。

年龄的增长与并发症的发生率增高和患乳腺癌的风险增加有关,尽管管理决策不应仅基于年龄,但NCCN指南建议对于年龄≥70岁的乳腺癌患者的治疗应该考虑到并发症。但是,在临床上试验中通常将该人群排除在外,关于存在多种并发症的老年患者的治疗与生存率相关性的数据很少,在这项对老年患者的雌激素受体阳性,病理性淋巴结阳性乳腺癌患者的当代分析中,有22.0%的患者接受了化疗。据我们所知,这是第一项评估老年乳腺癌合并并发症患者辅助化疗结果的回顾性研究。我们只评估雌激素受体阳性且病理性淋巴结阳性的患者,我们发现接受化疗的患者更年轻,淋巴结分期更高,疾病的分期更高。在这项对雌激素受体阳性,病理性淋巴结阳性合并多种并发症的老年乳腺癌患者的研究发现,接受辅助化疗与OS改善相关。接受化疗的患者更年轻,更有可能接受其他辅助治疗,这表明尽管存在多种合并症,但医生可以根据某些无法衡量的变量精心挑选可能从辅助化疗中受益的患者。另外,雌激素受体阳性的乳腺癌是一种异质性疾病,化疗的生存获益可能与Luminal亚型的差异有关。

原始出处:

Nina Tamirisa, Heather Lin, Yu Shen, et al. Association of Chemotherapy With Survival in Elderly Patients With Multiple Comorbidities and Estrogen Receptor–Positive, Node-Positive Breast Cancer. JAMA Oncology, 2020. DOI:10.1001/jamaoncol.2020.2388

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    2021-05-07 minlingfeng
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    2021-03-29 丁鹏鹏
  3. [GetPortalCommentsPageByObjectIdResponse(id=1865891, encodeId=5a1618658918d, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Fri May 07 03:48:49 CST 2021, time=2021-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758276, encodeId=9ce11e5827687, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Mar 29 12:48:49 CST 2021, time=2021-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811610, encodeId=d9c481161089, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f435296195, createdName=ms3000000449926787, createdTime=Thu Aug 20 23:02:53 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1378254, encodeId=a09c13e825463, content=<a href='/topic/show?id=c29b69004f9' target=_blank style='color:#2F92EE;'>#生存期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69004, encryptionId=c29b69004f9, topicName=生存期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e68e415, createdName=juliusluan78, createdTime=Thu Aug 20 03:48:49 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571220, encodeId=1d4b15e12203f, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Thu Aug 20 03:48:49 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811013, encodeId=43a3811013bb, content=👍🏻, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=25e55411955, createdName=ms5000000741733160, createdTime=Wed Aug 19 16:20:21 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036229, encodeId=d3271036229d8, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Aug 18 15:48:49 CST 2020, time=2020-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038093, encodeId=19f5103809395, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Aug 18 15:48:49 CST 2020, time=2020-08-18, status=1, ipAttribution=)]
    2020-08-20 ms3000000449926787

    学习了

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1865891, encodeId=5a1618658918d, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Fri May 07 03:48:49 CST 2021, time=2021-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758276, encodeId=9ce11e5827687, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Mar 29 12:48:49 CST 2021, time=2021-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811610, encodeId=d9c481161089, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f435296195, createdName=ms3000000449926787, createdTime=Thu Aug 20 23:02:53 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1378254, encodeId=a09c13e825463, content=<a href='/topic/show?id=c29b69004f9' target=_blank style='color:#2F92EE;'>#生存期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69004, encryptionId=c29b69004f9, topicName=生存期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e68e415, createdName=juliusluan78, createdTime=Thu Aug 20 03:48:49 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571220, encodeId=1d4b15e12203f, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Thu Aug 20 03:48:49 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811013, encodeId=43a3811013bb, content=👍🏻, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=25e55411955, createdName=ms5000000741733160, createdTime=Wed Aug 19 16:20:21 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036229, encodeId=d3271036229d8, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Aug 18 15:48:49 CST 2020, time=2020-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038093, encodeId=19f5103809395, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Aug 18 15:48:49 CST 2020, time=2020-08-18, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1865891, encodeId=5a1618658918d, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Fri May 07 03:48:49 CST 2021, time=2021-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758276, encodeId=9ce11e5827687, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Mar 29 12:48:49 CST 2021, time=2021-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811610, encodeId=d9c481161089, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f435296195, createdName=ms3000000449926787, createdTime=Thu Aug 20 23:02:53 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1378254, encodeId=a09c13e825463, content=<a href='/topic/show?id=c29b69004f9' target=_blank style='color:#2F92EE;'>#生存期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69004, encryptionId=c29b69004f9, topicName=生存期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e68e415, createdName=juliusluan78, createdTime=Thu Aug 20 03:48:49 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571220, encodeId=1d4b15e12203f, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Thu Aug 20 03:48:49 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811013, encodeId=43a3811013bb, content=👍🏻, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=25e55411955, createdName=ms5000000741733160, createdTime=Wed Aug 19 16:20:21 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036229, encodeId=d3271036229d8, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Aug 18 15:48:49 CST 2020, time=2020-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038093, encodeId=19f5103809395, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Aug 18 15:48:49 CST 2020, time=2020-08-18, status=1, ipAttribution=)]
    2020-08-19 ms5000000741733160

    👍🏻

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1865891, encodeId=5a1618658918d, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Fri May 07 03:48:49 CST 2021, time=2021-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758276, encodeId=9ce11e5827687, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Mar 29 12:48:49 CST 2021, time=2021-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811610, encodeId=d9c481161089, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f435296195, createdName=ms3000000449926787, createdTime=Thu Aug 20 23:02:53 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1378254, encodeId=a09c13e825463, content=<a href='/topic/show?id=c29b69004f9' target=_blank style='color:#2F92EE;'>#生存期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69004, encryptionId=c29b69004f9, topicName=生存期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e68e415, createdName=juliusluan78, createdTime=Thu Aug 20 03:48:49 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571220, encodeId=1d4b15e12203f, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Thu Aug 20 03:48:49 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811013, encodeId=43a3811013bb, content=👍🏻, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=25e55411955, createdName=ms5000000741733160, createdTime=Wed Aug 19 16:20:21 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036229, encodeId=d3271036229d8, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Aug 18 15:48:49 CST 2020, time=2020-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038093, encodeId=19f5103809395, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Aug 18 15:48:49 CST 2020, time=2020-08-18, status=1, ipAttribution=)]
    2020-08-18 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1865891, encodeId=5a1618658918d, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Fri May 07 03:48:49 CST 2021, time=2021-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758276, encodeId=9ce11e5827687, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Mar 29 12:48:49 CST 2021, time=2021-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811610, encodeId=d9c481161089, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f435296195, createdName=ms3000000449926787, createdTime=Thu Aug 20 23:02:53 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1378254, encodeId=a09c13e825463, content=<a href='/topic/show?id=c29b69004f9' target=_blank style='color:#2F92EE;'>#生存期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69004, encryptionId=c29b69004f9, topicName=生存期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e68e415, createdName=juliusluan78, createdTime=Thu Aug 20 03:48:49 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571220, encodeId=1d4b15e12203f, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Thu Aug 20 03:48:49 CST 2020, time=2020-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811013, encodeId=43a3811013bb, content=👍🏻, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=25e55411955, createdName=ms5000000741733160, createdTime=Wed Aug 19 16:20:21 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036229, encodeId=d3271036229d8, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Aug 18 15:48:49 CST 2020, time=2020-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038093, encodeId=19f5103809395, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Aug 18 15:48:49 CST 2020, time=2020-08-18, status=1, ipAttribution=)]
    2020-08-18 anti-cancer

    谢谢梅斯分享这么多精彩信息

    0

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