内分泌治疗（ET）和基于ET的方案是激素受体（HR）阳性和人表皮生长因子受体2（HER2）阴性的转移性乳腺癌（HR+/HER2- MBC）的首选一线治疗选项，而化学治疗（CT）通常用于临床实践。本研究的目的是调查ET和CT作为中国HR+/HER2- MBC患者的一线治疗的疗效和临床结果。从1996年1月1日至2018年9月30日，从中国临床肿瘤学会乳腺癌数据库中筛选出HR+/HER2- MBC患者。分析患者的初始和维持一线治疗、无进展生存期（PFS）和总生存期（OS）。在包括1877名患者的研究中，1215名患者（64.7%）接受CT，662名患者（35.3%）接受ET作为初始一线治疗。在总人群中，接受ET和CT作为初始一线治疗的患者在PFS和OS上没有统计学显着差异（PFS：12.0与11.0个月，P = 0.22；OS：54.0与49.0个月，P = 0.09），包括倾向性评分匹配人群。对于初始治疗至少3个月后没有疾病进展的患者，在总人群中，维持CT后换成ET（CT-ET队列，n = 449）和连续安排ET（ET队列，n = 527）的PFS均比连续安排CT（CT队列，n = 406）更长（CT-ET队列与CT队列：17.0 vs. 8.5个月；P <0.01；ET队列与CT队列：14.0 vs. 8.5个月；P <0.01），包括倾向性评分匹配人群。三个队列的OS得出与PFS相同的结果。ET作为初始一线治疗与CT具有类似的临床结果。对于初始CT后没有疾病进展的患者，切换到维持ET显示出优于连续安排CT的临床结果。版权所有© 2023年中国医学会，由 Wolters Kluwer，Inc.根据CC-BY-NC-ND许可制作。

Endocrine therapy (ET) and ET-based regimens are the preferred first-line treatment options for hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (HR+/HER2- MBC), while chemotherapy (CT) is commonly used in clinical practice. The aim of this study was to investigate the efficacy and clinical outcome of ET and CT as first-line treatment in Chinese patients with HR+/HER2- MBC.Patients with HR+/HER2- MBC were screened from the Chinese Society of Clinical Oncology Breast Cancer database between January 1st, 1996 and September 30th, 2018. The initial and maintenance first-line treatment, progression-free survival (PFS), and overall survival (OS) of patients were analyzed.Among the 1877 included patients, 1215 (64.7%) received CT and 662 (35.3%) received ET as initial first-line treatment. There were no statistically significant differences in PFS and OS between patients receiving ET and CT as initial first-line treatment in the total population (PFS: 12.0 vs. 11.0 months, P = 0.22; OS: 54.0 vs. 49.0 months, P =0.09) and propensity score matched population. For patients without disease progression after at least 3 months of initial therapy, maintenance ET following initial CT (CT-ET cohort, n = 449) and continuous schedule of ET (ET cohort, n = 527) had longer PFS than continuous schedule of CT (CT cohort, n = 406) in the total population (CT-ET cohort vs. CT cohort: 17.0 vs. 8.5 months; P <0.01; ET cohort vs. CT cohort: 14.0 vs. 8.5 months; P <0.01) and propensity score matched population. OS in the three cohorts yielded the same results as PFS.ET was associated with similar clinical outcome to CT as initial first-line treatment. For patients without disease progression after initial CT, switching to maintenance ET showed superiority in clinical outcome over continuous schedule of CT.Copyright © 2023 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.