卡培他滨相关的红细胞平均体积增加可能是转移性结直肠癌患者治疗反应和生存的预测标志物。

Capecitabine-related increased mean corpuscular volume of red blood cell may be a predictive marker of treatment response and survival in patients with metastatic colorectal cancer.

作者信息

Cokmert Suna, Demir Lutfiye, Can Alper, Akyol Murat, Vedat Bayoglu Ibrahim, Dirican Ahmet, Kucukzeybek Yuksel, Erten Cigdem, Oktay Tarhan Mustafa

机构信息

Department of Medical Oncology, Katip Celebi University, Izmir Ataturk Training and Research Hospital, Izmir, Turkey.

出版信息

J BUON. 2014 Jan-Mar;19(1):75-82.

PMID:24659646

Abstract

PURPOSE

Erythrocyte mean corpuscular volume (MCV) increase has been described in patients treated with capecitabine. In this study, we sought to evaluate the potential association of the erythrocyte MCV increase with tumor response and survival in patients with metastatic colorectal cancer (mCRC) treated with capecitabine.

METHODS

A retrospective review of 131 patients with mCRC who were treated with capecitabine for at least 3 months at the Izmir Training and Research Hospital was undertaken. Complete blood count (CBC) including red blood cell indices were recorded at baseline and after 9 weeks from capecitabine treatment.

RESULTS

The mean patient age was 57.9 years (range 28- 82). In patients treated with capecitabine, MCV increased significantly at 9 weeks compared with baseline (p=0.000). Median ΔMCV [(post-treatment MCV values) - (baseline MCV values)] level was 9.3 fL. Patients were grouped according to ΔMCV into two groups (> 9.3 or ≥ 9.3) in order to carry out survival analysis and correlation with tumor response. ΔMCV was >9.3 in 65 patients and ≤9.3 in 66 patients. Fifty-six of the 65 patients with ΔMCV levels >9.3 and 37 of the 66 patients with ΔMCV levels ≤9.3 had a clinical benefit (complete response + partial response + stable disease) from capecitabine treatment (p=0.000). The difference between progression-free survival (PFS) and overall survival (OS) of the patients who had ΔMCV>9.3 and those who had ≤9.3 was statistically significant (9.48 and 6.94 months, p=0.001 respectively; and 17.5 and 13.6 months respectively, p=0.018). Univariate analysis suggested that a favorable prognosis for OS and PFS was associated with MCV increase (p=0.000). In multivariate analysis, MCV increase was independently associated with favorable survival outcomes.

CONCLUSIONS

Erythrocyte MCV increase may be used as a predictive marker for treatment response, PFS and OS in patients with mCRC treated with capecitabine.

摘要

目的

已观察到接受卡培他滨治疗的患者红细胞平均体积（MCV）增加。在本研究中，我们试图评估转移性结直肠癌（mCRC）患者接受卡培他滨治疗时红细胞MCV增加与肿瘤反应及生存之间的潜在关联。

方法

对在伊兹密尔培训与研究医院接受卡培他滨治疗至少3个月的131例mCRC患者进行回顾性分析。在基线时以及卡培他滨治疗9周后记录包括红细胞指数在内的全血细胞计数（CBC）。

结果

患者的平均年龄为57.9岁（范围28 - 82岁）。接受卡培他滨治疗的患者，与基线相比，9周时MCV显著增加（p = 0.000）。MCV变化中位数[（治疗后MCV值） - （基线MCV值）]为9.3 fL。为进行生存分析以及与肿瘤反应的相关性分析，根据MCV变化将患者分为两组（> 9.3或≥ 9.3）。65例患者的MCV变化> 9.3，66例患者的MCV变化≤ 9.3。65例MCV变化> 9.3的患者中有56例，66例MCV变化≤ 9.3的患者中有37例从卡培他滨治疗中获得临床获益（完全缓解 + 部分缓解 + 病情稳定）（p = 0.000）。MCV变化> 9.3的患者与MCV变化≤ 9.3的患者之间的无进展生存期（PFS）和总生存期（OS）差异具有统计学意义（分别为9.48个月和6.94个月，p = 0.001；以及分别为17.5个月和13.6个月，p = 0.018）。单因素分析表明，OS和PFS的良好预后与MCV增加相关（p = 0.000）。多因素分析中，MCV增加与良好的生存结局独立相关。