一线多西他赛治疗的去势抵抗性前列腺癌患者治疗前中性粒细胞与淋巴细胞比值的预后影响
Prognostic impact of pretreatment neutrophil-to-lymphocyte ratio in castration-resistant prostate cancer patients treated with first-line docetaxel.
作者信息
Buttigliero Consuelo, Pisano Chiara, Tucci Marcello, Vignani Francesca, Bertaglia Valentina, Iaconis Davide, Guglielmini Pamela, Numico Gianmauro, Scagliotti Giorgio V, Di Maio Massimo
机构信息
a Division of Medical Oncology, Department of Oncology , University of Turin, San Luigi Gonzaga Hospital , Turin , Italy.
b Oncology Unit , SS Antonio e Biagio e Cesare Arrigo Hospital , Alessandria , Italy.
出版信息
Acta Oncol. 2017 Apr;56(4):555-562. doi: 10.1080/0284186X.2016.1260772. Epub 2017 Jan 9.
BACKGROUND
The neutrophil-to-lymphocyte ratio (NLR), a measure of systemic inflammatory response, has been associated with poor outcome in several solid tumors, including prostate cancer. We retrospectively investigated the prognostic role of pretreatment NLR in metastatic castration-resistant prostate cancer (mCRPC) patients treated with first-line docetaxel.
METHODS
All CRPC patients treated with first-line docetaxel at two Italian institutions, with available data about baseline neutrophil and lymphocyte values, were included in this retrospective analysis. Patients were divided in two groups according to NLR ratio (low NLR: ≤3; high NLR: >3). Outcome measures were progression-free (PFS) and overall survival (OS), measured from the start of docetaxel treatment. Univariate and multivariate analysis (adjusting for baseline prostate-specific antigen, alkaline phosphatase, lactate dehydrogenase, hemoglobin, albumin, performance status, use of opioids and presence of visceral disease) were performed.
RESULTS
One hundred and seventy-nine patients treated between 2004 and 2016 were analyzed and 110 had information about pretreatment NLR. Forty-six patients (42%) had low NLR and 64 (58%) had high NLR. Median PFS was 8.8 months in patients with low NLR versus 7.3 months in those with high NLR [hazard ratio (HR) 1.12, 95% confidence interval (CI) 0.75-1.69, p = .58]. Median OS was 34.9 months in patients with low NLR versus 20.2 months in those with high NLR (HR 1.85, 95% CI 1.07-3.19, p = .02). At multivariate analysis, NLR confirmed an independent impact on OS (HR 3.16, 95% CI 1.50-6.65, p = .002).
CONCLUSION
In this retrospective series, metastatic CRPC patients who started first-line docetaxel with a low pretreatment NLR had a significantly better survival. In addition to known prognostic factors, NLR can be useful to improve prognostic evaluation of patients in this setting.
背景
中性粒细胞与淋巴细胞比值（NLR）是一种全身炎症反应指标，已被证明与包括前列腺癌在内的多种实体肿瘤的不良预后相关。我们回顾性研究了一线多西他赛治疗的转移性去势抵抗性前列腺癌（mCRPC）患者治疗前NLR的预后作用。
方法
本回顾性分析纳入了在两家意大利机构接受一线多西他赛治疗且有基线中性粒细胞和淋巴细胞值可用数据的所有CRPC患者。根据NLR比值将患者分为两组（低NLR：≤3；高NLR：>3）。观察指标为从多西他赛治疗开始测量的无进展生存期（PFS）和总生存期（OS）。进行了单因素和多因素分析（校正基线前列腺特异性抗原、碱性磷酸酶、乳酸脱氢酶、血红蛋白、白蛋白、体能状态、阿片类药物使用情况和内脏疾病的存在）。
结果
分析了2004年至2016年间接受治疗的179例患者，其中110例有治疗前NLR的信息。46例患者（42%）NLR低，64例（58%）NLR高。低NLR患者的中位PFS为8.8个月，而高NLR患者为7.3个月[风险比（HR）1.12，95%置信区间（CI）0.75-1.69，p = 0.58]。低NLR患者的中位OS为34.9个月，而高NLR患者为20.2个月（HR 1.85，95%CI 1.07-3.19，p = 0.02）。在多因素分析中，NLR证实对OS有独立影响（HR 3.16，95%CI 1.50-6.65，p = 0.002）。
结论
在这个回顾性系列中，一线多西他赛治疗前NLR低的转移性CRPC患者生存期明显更好。除了已知的预后因素外，NLR有助于改善该情况下患者的预后评估。
Zotero 插件