Satapathy Swayamjeet, Bhattacharya Anish, Sood Ashwani, Kapoor Rakesh, Gupta Rajesh, Sood Apurva, Sharma Prashant, Khosla Divya, Mittal Bhagwant Rai
Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Radiotherapy, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Cancer Biother Radiopharm. 2022 Feb;37(1):23-29. doi: 10.1089/cbr.2021.0053. Epub 2021 Jun 29.
Chronic inflammation has been linked to the development and prognosis of neuroendocrine tumors (NETs). The current study intended to evaluate the role of peripheral hematological inflammatory markers, viz. the platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio, and monocyte-lymphocyte ratio, as predictors of treatment outcomes in patients with advanced NETs after Lutetium-177(Lu)-DOTATATE therapy. Data of consecutive patients with advanced metastatic and/or inoperable NETs treated with Lu-DOTATATE from the year 2012 to 2019 at the authors' center were retrospectively analyzed. Forty-two NET patients (median age: 49.5 years) received a median cumulative activity of 29.6 GBq of Lu-DOTATATE over 2-5 cycles at 8-12-week intervals. The median progression-free survival (PFS) of the study cohort was 30 months (95% confidence interval, CI: 18.2-41.9 months). A baseline PLR ≥173.1 was found to be a significant predictor of poor PFS with a univariate hazard ratio of 3.82 (95% CI: 1.21-12.03); however, the association was not significant on multivariate analysis. The median overall survival was not reached and none of the parameters were significantly associated with it. A higher baseline PLR was shown to be associated with a negative outcome on PFS after Lu-DOTATATE therapy and is a promising marker for future larger studies.
慢性炎症与神经内分泌肿瘤（NETs）的发生发展及预后相关。本研究旨在评估外周血液炎症标志物，即血小板淋巴细胞比值（PLR）、中性粒细胞淋巴细胞比值和单核细胞淋巴细胞比值，作为镥-177（Lu）-DOTATATE治疗后晚期NETs患者治疗结局预测指标的作用。对作者所在中心2012年至2019年期间接受Lu-DOTATATE治疗的连续晚期转移性和/或不可切除NETs患者的数据进行回顾性分析。42例NET患者（中位年龄：49.5岁）在8至12周的间隔内接受了2至5个周期的Lu-DOTATATE治疗，中位累积活度为29.6GBq。研究队列的中位无进展生存期（PFS）为30个月（95%置信区间，CI：18.2-41.9个月）。发现基线PLR≥173.1是PFS较差的显著预测指标，单因素风险比为3.82（95%CI：1.21-12.03）；然而，多因素分析显示该关联不显著。总生存期未达到中位值，且没有参数与之显著相关。较高的基线PLR显示与Lu-DOTATATE治疗后的PFS不良结局相关，是未来更大规模研究的一个有前景的标志物。
