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与钇-90 玻璃微球放射性栓塞治疗结直肠癌肝转移的生存和良好预后相关的生物标志物:单中心经验。

Biomarkers associated with survival and favourable outcome of radioembolization with yttrium-90 glass microspheres for colon cancer liver metastases: Single centre experience.

机构信息

Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain; IBS, Granada Bio-Health Research Institute, Granada, Spain.

Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, Spain.

出版信息

Rev Esp Med Nucl Imagen Mol (Engl Ed). 2022 Jul-Aug;41(4):231-238. doi: 10.1016/j.remnie.2021.08.001. Epub 2021 Aug 26.

Abstract

OBJECTIVE

To determine the therapeutic effectiveness and safety of transarterial radioembolization (TARE) with Yttrium-90 in patients with colorectal cancer (CRC) liver metastases and to evaluate the prognostic value of different biomarkers.

MATERIAL AND METHODS

This prospective longitudinal study enrolled consecutive patients with CRC liver metastases treated with TARE between November 2015 and june 2020. The therapeutic response at three and six months (RECIST1.1 criteria) and the relationship of biomarkers with therapeutic response, by calculating objective tumor response rates (ORR) and disease control (DCR), and overall survival (OS) and progression-free (PFS).

RESULTS

Thirty TAREs were performed in 23 patients (mean age, 61.61 ± 9.13 years; 56.5% male). At three months, the objective response rate (ORR) was 16.7% and the disease control rate (DCR) 53.3%. At six months, the disease progressed in 80%. The ORR and DCR were significantly associated with age at diagnosis (P = 0.047), previous bevacizumab treatment (P = 0.008), pre-TARE haemoglobin (P = 0.008), NLR (P = 0.040), pre-TARE albumin (P = 0.012), pre-TARE ALT (P = 0.023) and tumour-absorbed dose > 115 Gy (P = 0.033). Median overall survival (OS) was 12 months (95% CI, 4.75-19.25 months) and median progression-free survival (PFS) 3 months (95% CI, 2.41-3.59). OS was significantly associated with primary tumour resection (P = 0.019), KRAS mutation (HR: 5.15; P = 0.024), pre-TARE haemoglobin (HR: 0.50; p = 0.009), pre-TARE NLR (HR: 1.65; P = 0.005) and PLR (HR: 1.01; P = 0.042).

CONCLUSION

TARE prognosis and therapeutic response were predicted by different biomarkers, ranging from biochemical parameters to tumour dosimetrics.

摘要

目的

确定钇-90 经动脉放射栓塞术(TARE)治疗结直肠癌(CRC)肝转移患者的疗效和安全性,并评估不同生物标志物的预后价值。

材料和方法

本前瞻性纵向研究纳入了 2015 年 11 月至 2020 年 6 月期间接受 TARE 治疗的连续 CRC 肝转移患者。根据 RECIST1.1 标准,在三个月和六个月时评估治疗反应,并通过计算客观肿瘤反应率(ORR)和疾病控制率(DCR)以及总生存率(OS)和无进展生存率(PFS),评估生物标志物与治疗反应的关系。

结果

23 例患者共进行了 30 次 TARE(平均年龄 61.61±9.13 岁;56.5%为男性)。在三个月时,客观缓解率(ORR)为 16.7%,疾病控制率(DCR)为 53.3%。在六个月时,80%的患者疾病进展。ORR 和 DCR 与诊断时的年龄(P=0.047)、之前贝伐珠单抗治疗(P=0.008)、TARE 前血红蛋白(P=0.008)、中性粒细胞与淋巴细胞比值(NLR)(P=0.040)、TARE 前白蛋白(P=0.012)、TARE 前丙氨酸氨基转移酶(ALT)(P=0.023)和肿瘤吸收剂量>115 Gy(P=0.033)显著相关。中位总生存期(OS)为 12 个月(95%CI:4.75-19.25 个月),中位无进展生存期(PFS)为 3 个月(95%CI:2.41-3.59)。OS 与原发肿瘤切除术(P=0.019)、KRAS 突变(HR:5.15;P=0.024)、TARE 前血红蛋白(HR:0.50;P=0.009)、TARE 前 NLR(HR:1.65;P=0.005)和 PLR(HR:1.01;P=0.042)显著相关。

结论

不同的生物标志物(从生化参数到肿瘤剂量学)可以预测 TARE 的预后和治疗反应。

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