吉西他滨难治性胆管癌患者的改良格拉斯哥预后评分
The Modified Glasgow Prognostic Score in Patients with Gemcitabine-refractory Biliary Tract Cancer.
作者信息
Okano Naohiro, Kasuga Akiyoshi, Kawai Kirio, Yamauchi Yoshiya, Kobayashi Takaaki, Naruge Daisuke, Nagashima Fumio, Furuse Junji
机构信息
Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan
Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan.
出版信息
Anticancer Res. 2018 Mar;38(3):1755-1761. doi: 10.21873/anticanres.12412.
BACKGROUND
No standard second-line chemotherapy has been yet established for gemcitabine-refractory biliary tract cancer (BTC).
PATIENTS AND METHODS
We conducted multivariable Cox regression analysis to examine the prognostic factors for overall survival (OS) in patients who had received gemcitabine-based treatment.
RESULTS
Forty-six patients received second-line chemotherapy. The median serum carbohydrate antigen 19-9 (CA 19-9) value was 487 U/ml. The modified Glasgow prognostic score (mGPS) was: 0 (n=24), 1 (n=10), or 2 (n=10). The second-line chemotherapy included: S-1 in 20 patients, gemcitabine-based in 20, and tyrosine kinase inhibitors in five. The median OS was 8.3 months, and the median progression-free survival was 3.0 months. Multivariate analysis identified serum CA 19-9 ≥500 U/ml, mGPS ≥1, and presence of liver metastasis as significant prognostic factors for OS.
CONCLUSION
Second-line chemotherapy for gemcitabine-refractory BTC remains inadequate. Randomized trials with appropriate stratification criteria are required.
背景
对于吉西他滨难治性胆管癌（BTC），尚未建立标准的二线化疗方案。
患者与方法
我们进行了多变量Cox回归分析，以研究接受基于吉西他滨治疗的患者的总生存期（OS）的预后因素。
结果
46例患者接受了二线化疗。血清糖类抗原19-9（CA 19-9）的中位值为487 U/ml。改良格拉斯哥预后评分（mGPS）为：0（n = 24）、1（n = 10）或2（n = 10）。二线化疗包括：20例患者使用S-1，20例使用基于吉西他滨的方案，5例使用酪氨酸激酶抑制剂。中位OS为8.3个月，中位无进展生存期为3.0个月。多变量分析确定血清CA 19-9≥500 U/ml、mGPS≥1和存在肝转移是OS的显著预后因素。
结论
吉西他滨难治性BTC的二线化疗仍然不足。需要进行具有适当分层标准的随机试验。
Zotero 插件