Department of Radiation Oncology, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan.
J Radiat Res. 2020 Jul 6;61(4):616-621. doi: 10.1093/jrr/rraa039.
In patients with various cancers, modified Glasgow prognostic score (mGPS) before treatment has predicted prognoses after antitumor therapy. This study aimed to assess whether pretreatment mGPS also has predictive value in patients with muscle-invasive bladder cancer (MIBC) after radiotherapy. A retrospective review accumulated 98 consecutive MIBC patients treated with definitive 3D-conformal radiotherapy from January 2011 to December 2016 in a single center. It included cT2-4bN0-3M0 patients with a median age of 79 years (range: 49 to 95 years). Radiotherapy was delivered at 60-66 Gy for bladder cancer. Patients were categorized in terms of their pretreatment serum albumin and C-reactive protein (CRP) values as mGPS_0, mGPS_1, and mGPS_2. Among them, cumulative overall survival (OS) rates were compared by Kaplan-Meier plots with log-rank tests. The number of patients with mGPS_0, mGPS_1, and mGPS_2 were 40, 40, and 18, respectively. The median follow-up time for all patients was 19 months (range: 2-73 months). The 2-year OS rate for all patients was 75.7%. The 2-year OS rates for mGPS_0, mGPS_1, and mGPS_2 were 85.1%, 71.3%, and 60.9%, respectively. Kaplan-Meier curves revealed a significantly higher cumulative OS rate for mGPS_0 compared with mGPS_1 and mGPS_2 (P = 0.003). Using multivariate Cox regression analysis, mGPS_0 and good performance status were associated with favorable OS rates, of which mGPS_0 was more significant (Hazard ratio 2.74, 95% CI 1.30-5.57, P = 0.008). Modified Glasgow prognostic score may be a novel biomarker that can predict survival in patients with MIBC after radiotherapy.
在接受各种癌症治疗的患者中,治疗前改良格拉斯哥预后评分(mGPS)可预测抗肿瘤治疗后的预后。本研究旨在评估治疗前 mGPS 是否也可预测接受根治性三维适形放疗的肌层浸润性膀胱癌(MIBC)患者的预后。本研究回顾性分析了 2011 年 1 月至 2016 年 12 月在单中心接受根治性 3D 适形放疗的 98 例 MIBC 患者。患者中位年龄为 79 岁(范围:49 岁-95 岁),均为 cT2-4bN0-3M0。放疗剂量为 60-66Gy。根据治疗前血清白蛋白和 C 反应蛋白(CRP)值将患者分为 mGPS_0、mGPS_1 和 mGPS_2。通过 Kaplan-Meier 曲线和对数秩检验比较各组的累积总生存(OS)率。mGPS_0、mGPS_1 和 mGPS_2 患者分别为 40 例、40 例和 18 例。所有患者的中位随访时间为 19 个月(范围:2-73 个月)。所有患者的 2 年 OS 率为 75.7%。mGPS_0、mGPS_1 和 mGPS_2 的 2 年 OS 率分别为 85.1%、71.3%和 60.9%。Kaplan-Meier 曲线显示 mGPS_0 组的累积 OS 率显著高于 mGPS_1 组和 mGPS_2 组(P=0.003)。多因素 Cox 回归分析显示,mGPS_0 和良好的体力状态与有利的 OS 率相关,其中 mGPS_0 更为显著(风险比 2.74,95%CI 1.30-5.57,P=0.008)。改良格拉斯哥预后评分可能是预测 MIBC 患者放疗后生存的一种新的生物标志物。