Wei Qing, Yuan Xing, Xu Qi, Li Jingjing, Chen Lei, Ying Jieer
Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou 310022, People's Republic of China.
Cancer Manag Res. 2020 Aug 7;12:7009-7019. doi: 10.2147/CMAR.S256074. eCollection 2020.
This retrospective study evaluated the prognostic significance of hemoglobin (Hb) levels in patients (pts) with unresectable locally advanced or metastatic gastric cancer who have not previously received chemotherapy.
We screened 249 pts with advanced gastric cancer, who were categorized into four groups, namely, non-anemia (normal Hb levels), mild (10 g/dl to normal), moderate (8-10 g/dl), and severe anemia groups (<8 g/dl), to study the prognostic significance of Hb levels. We also examined the correlation between changes in Hb levels and treatment effects via imaging during the treatment course.
The objective response rate (ORR) was 47.4% for pts with anemia versus 43.4% for pts without anemia (=0.536). Hemoglobin levels were reduced by 0.51 ± 1.86 and 1.93 ± 1.33 g/dl after chemotherapy versus before chemotherapy in the disease control group and progressive groups, respectively (P=0.002). The median progression-free survival (mPFS) of first-line chemotherapy in all pts was 6.3 months. Specifically, the mPFS was 5.7 months in pts with severe anemia, compared with 6.4 months for pts with non-severe anemia (Hb≥8g/dl). The median overall survival (mOS) of all pts was 14.0 months. In particular, the mOS was 15.0 months for pts with non-anemia and mild anemia (Hb≥10g/dl) versus 11.5 months for pts with moderate or severe anemia. In multivariate analysis, ascites and decreased Hb post-chemotherapy were identified as independent prognostic indicators for PFS and OS.
Our findings indicate that Hb levels are associated with the prognosis in the first-line chemotherapy for pts with advanced gastric cancer. Pts with progressive disease experience a larger decrease in Hb levels, and those with baseline Hb levels ≥10 g/dl experience longer OS.
本回顾性研究评估了血红蛋白（Hb）水平对既往未接受过化疗的不可切除局部晚期或转移性胃癌患者（pts）的预后意义。
我们筛选了249例晚期胃癌患者，将其分为四组，即非贫血组（Hb水平正常）、轻度贫血组（10 g/dl至正常）、中度贫血组（8 - 10 g/dl）和重度贫血组（<8 g/dl），以研究Hb水平的预后意义。我们还通过治疗过程中的影像学检查了Hb水平变化与治疗效果之间的相关性。
贫血患者的客观缓解率（ORR）为47.4%，非贫血患者为43.4%（P = 0.536）。疾病控制组和进展组化疗后Hb水平分别比化疗前降低了0.51±1.86 g/dl和1.93±1.33 g/dl（P = 0.002）。所有患者一线化疗的中位无进展生存期（mPFS）为6.3个月。具体而言，重度贫血患者的mPFS为5.7个月，非重度贫血（Hb≥8g/dl）患者为6.4个月。所有患者的中位总生存期（mOS）为14.0个月。特别是，非贫血和轻度贫血（Hb≥10g/dl）患者的mOS为15.0个月，中度或重度贫血患者为11.5个月。多因素分析中，腹水和化疗后Hb降低被确定为PFS和OS的独立预后指标。
我们的研究结果表明，Hb水平与晚期胃癌患者一线化疗的预后相关。疾病进展患者的Hb水平下降幅度更大，基线Hb水平≥10 g/dl的患者OS更长。
