Department of Oncology, Ospedale Civile di Sanremo, Sanremo, Italy.
Department of Oncology, Ospedale Civile di Sanremo, Sanremo, Italy.
Pancreatology. 2020 Sep;20(6):1189-1194. doi: 10.1016/j.pan.2020.07.397. Epub 2020 Jul 25.
Recently, measures of tumor growth kinetics calculated by carbohydrate antigen 19-9 (CA 19-9) determinations after cytotoxic chemotherapy (CHT) have been reported as effective prognostic indicators in locally-advanced unresectable and metastatic pancreatic adenocarcinoma (mPDAC). The study aims to evaluate the prognostic role of tumor kinetics measured by CA 19-9 in patients with mPDAC, measuring it by three different ways.
Patients with mPDAC receiving a first-line CHT between 2009 and 2017 were identified, and those for whom CA 19-9 data were available were enrolled. Three CA 19-9-related variables were calculated: CA 19-9 related reduction rate (RR) and tumor growth rate (G), after 8 weeks of CHT, tumor growth and inflammation index (TGII), after 90 days of CHT. The relationships with the outcome were analysed, and a Cox model has been build with each of the three variables.
Of 118 patients only 48 were eligible for the analysis. RR, G, or TGII appear as significant prognostic factors, and, after multivariate analysis, a reduction rate of 20% the baseline or more was associated with good survival (HR 0.321; CIs 0.156-0.661) as well as a G > -0.4%/day (HR 2.114; CIs 1.034-4.321), whereas TGII >190 was not correlated with the outcome (HR 1.788; CIs 0.789-4.055).
In patients with mPDAC, after 8 weeks of first-line CHT, CA 19-9-related tumor reduction or growth rate appear as valuable prognostic factors.
最近，通过细胞毒性化疗（CHT）后测定肿瘤相关碳水化合物抗原 19-9（CA 19-9）计算的肿瘤生长动力学指标被报道为局部晚期不可切除和转移性胰腺腺癌（mPDAC）的有效预后指标。本研究旨在通过三种不同方法评估 CA 19-9 测量的肿瘤动力学在 mPDAC 患者中的预后作用。
确定了 2009 年至 2017 年间接受一线 CHT 的 mPDAC 患者，并招募了可获得 CA 19-9 数据的患者。计算了三种 CA 19-9 相关变量：CHT 后 8 周的 CA 19-9 相关下降率（RR）和肿瘤生长率（G）、CHT 后 90 天的肿瘤生长和炎症指数（TGII）。分析了与结局的关系，并为每个变量构建了 Cox 模型。
在 118 名患者中，仅有 48 名符合分析条件。RR、G 或 TGII 是显著的预后因素，经过多变量分析，基线下降率超过 20%与良好的生存相关（HR 0.321；95%CI 0.156-0.661），G >-0.4%/天（HR 2.114；95%CI 1.034-4.321）也是如此，而 TGII >190 与结局无关（HR 1.788；95%CI 0.789-4.055）。
在接受一线 CHT 后的 mPDAC 患者中，CA 19-9 相关的肿瘤缩小或生长率是有价值的预后因素。
