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格拉斯哥预后评分:在开具姑息性放射治疗处方时的有用信息。

The Glasgow prognostic score: Useful information when prescribing palliative radiotherapy.

作者信息

Nieder Carsten, Mannsåker Bård, Dalhaug Astrid, Pawinski Adam, Haukland Ellinor

机构信息

Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, N-9037 Tromsø, Norway.

Department of Oncology and Palliative Medicine, Nordland Hospital, N-8092 Bodø, Norway.

出版信息

Mol Clin Oncol. 2017 Jun;6(6):811-816. doi: 10.3892/mco.2017.1228. Epub 2017 Apr 26.

Abstract

The purpose of the present retrospective study was to investigate whether a score reflecting systemic inflammatory processes [the Glasgow Prognostic Score (GPS)] provides relevant information for radiation oncologists. GPS is a three-tiered score [0: normal C-reactive protein (CRP) and albumin; 1: one abnormal result; 2: increased CRP and low albumin]. Correlations between disease type and extent, resource utilization, survival and GPS were analyzed in 703 patients. In the subgroup with GPS 2, significantly higher rates of lung, adrenal gland and liver metastases were observed. An increasing GPS score was associated with a higher likelihood of anemia, leukocytosis and thrombocytosis. Comparable findings were made regarding utilization of palliative care resources, need for blood transfusion and intravenous administration of antibiotics. Compared with GPS 0 or 1, more patients with GPS 2 did not complete their prescribed course of radiotherapy. One-third of patients with GPS 2 received treatment during the final month of life. Multivariate analysis demonstrated that GPS was a significant prognostic factor for overall survival (median, 479, 136, and 61 days, for GPS 0, 1 and 2, respectively). In patients with GPS 2 and additional leukocytosis, the median survival was 38 days. In conclusion, GPS provides important prognostic information. This biomarker-based score may be considered for deciding fractionation, and should be validated further.

摘要

本回顾性研究的目的是调查反映全身炎症过程的评分[格拉斯哥预后评分(GPS)]是否能为放射肿瘤学家提供相关信息。GPS是一个三级评分[0:C反应蛋白(CRP)和白蛋白正常;1:一项结果异常;2:CRP升高且白蛋白降低]。分析了703例患者的疾病类型和范围、资源利用、生存率与GPS之间的相关性。在GPS为2的亚组中,观察到肺、肾上腺和肝转移的发生率显著更高。GPS评分升高与贫血、白细胞增多和血小板增多的可能性增加相关。在姑息治疗资源利用、输血需求和抗生素静脉给药方面也有类似发现。与GPS为0或1相比,更多GPS为2的患者未完成规定的放疗疗程。三分之一的GPS为2的患者在生命的最后一个月接受了治疗。多因素分析表明,GPS是总生存的一个显著预后因素(GPS为0、1和2时的中位生存期分别为479天、136天和61天)。在GPS为2且伴有白细胞增多的患者中,中位生存期为38天。总之,GPS提供了重要的预后信息。这种基于生物标志物的评分可用于决定分割放疗,应进一步验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/955c/5451880/82edc2d960a2/mco-06-06-0811-g00.jpg

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