Morganti Alessio G, Forni Franca, Macchia Gabriella, Valentini Vincenzo, Smaniotto Daniela, Trodella Lucio, Balducci Mario, Cellini Numa
Department of Radiation Therapy, Università Cattolica del S. Cuore, Campobasso, Italy.
Strahlenther Onkol. 2003 Feb;179(2):87-92. doi: 10.1007/s00066-003-1043-y.
To evaluate, in patients with locally advanced pancreatic carcinoma undergoing concomitant chemoradiation, the impact of pretreatment hemoglobin (Hb) concentration on the outcome in terms of clinical response, local control, metastasis-free survival, disease-free survival, and overall survival.
30 patients undergoing concomitant chemoradiation (5-fluorouracil [5-FU], 1,000 mg/m(2)/day, continuous i.v. infusion days 1-4 of radiotherapy) and external beam radiotherapy (50.4-59.4 Gy) were divided into two groups based on pretreatment median Hb value (11.5 g/dl). The potential prognostic factors examined besides Hb concentration were: tumor site (head vs body-tail), sex (female vs male), cN (cN0 vs nC1), dose of external beam radiotherapy (50.4 Gy vs 59.4 Gy), presence of jaundice at diagnosis (yes vs no), weight loss at diagnosis (> or = 5 kg vs < 5 kg), epigastric-lumbar pain at diagnosis (yes vs no), maximum tumor diameter (< 40 mm vs > or = 40 mm).
Pretreatment Hb ranged between 9.6 and 15.0 g/dl. No statistically significant differences were observed as for clinical response and local control between patients with an Hb < or = 11.5 g/dl and those with an Hb > 11.5 g/dl. Metastasis-free survival was 5.1 months in patients with an Hb < or = 11.5 g/dl and 10.7 months in patients with an Hb > 11.5 g/dl (p = 0,010). Median actuarial disease-free survival was 5.1 and 10.2 months in patients with an Hb < or = 11.5 and > 11.5 g/dl, respectively (p = 0.026). Median actuarial overall survival was 7.5 and 10.3 months in patients with an Hb < or = 11.5 and > 11.5 g/dl; respectively (p = 0.039). On multivariate analysis, Hb concentration at diagnosis was the only factor prognostically correlated with metastasis-free survival (p = 0.026), disease-free survival (p = 0.032), and overall survival (p = 0.048).
In a group of patients with locally advanced pancreatic carcinoma treated with chemoradiation, a significant correlation was observed between pretreatment Hb levels and metastasis-free survival, disease-free survival, and overall survival.
评估局部晚期胰腺癌患者同步放化疗时，治疗前血红蛋白（Hb）浓度对临床反应、局部控制、无转移生存期、无病生存期及总生存期的影响。
30例接受同步放化疗（5-氟尿嘧啶[5-FU]，1000mg/m²/天，放疗第1 - 4天持续静脉输注）及外照射放疗（50.4 - 59.4Gy）的患者，根据治疗前Hb中位值（11.5g/dl）分为两组。除Hb浓度外，检测的潜在预后因素包括：肿瘤部位（胰头 vs 胰体尾）、性别（女性 vs 男性）、cN（cN0 vs cN1）、外照射放疗剂量（50.4Gy vs 59.4Gy）、诊断时黄疸情况（是 vs 否）、诊断时体重减轻情况（≥5kg vs <5kg）、诊断时上腹部-腰部疼痛情况（是 vs 否）、最大肿瘤直径（<40mm vs ≥40mm）。
治疗前Hb范围为9.6至15.0g/dl。Hb≤11.5g/dl的患者与Hb>11.5g/dl的患者在临床反应和局部控制方面未观察到统计学显著差异。Hb≤11.5g/dl的患者无转移生存期为5.1个月，Hb>11.5g/dl的患者为10.7个月（p = 0.010）。Hb≤11.5g/dl和>11.5g/dl的患者中位精算无病生存期分别为5.1个月和10.2个月（p = 0.026）。Hb≤11.5g/dl和>11.5g/dl的患者中位精算总生存期分别为7.5个月和10.3个月（p = 0.039）。多因素分析显示，诊断时Hb浓度是与无转移生存期（p = 0.026）、无病生存期（p = 0.032）和总生存期（p = 0.048）预后相关的唯一因素。
在一组接受放化疗的局部晚期胰腺癌患者中，观察到治疗前Hb水平与无转移生存期、无病生存期和总生存期之间存在显著相关性。
