接受一线吉西他滨联合紫杉醇治疗晚期胰腺腺癌患者的胰酶替代疗法
Pancreatic Enzyme Replacement Therapy in Patients Undergoing First-Line Gemcitabine Plus -paclitaxel for Advanced Pancreatic Adenocarcinoma.
作者信息
Trestini Ilaria, Carbognin Luisa, Peretti Umberto, Sperduti Isabella, Caldart Alberto, Tregnago Daniela, Avancini Alice, Auriemma Alessandra, Orsi Giulia, Pilotto Sara, Frulloni Luca, Capurso Gabriele, Bria Emilio, Reni Michele, Tortora Giampaolo, Milella Michele
机构信息
Section of Oncology, Department of Medicine, University of Verona, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy.
Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
出版信息
Front Oncol. 2021 Sep 9;11:688889. doi: 10.3389/fonc.2021.688889. eCollection 2021.
BACKGROUND
The clinical consequences of pancreatic exocrine insufficiency and its treatment in advanced pancreatic ductal adenocarcinoma (PDAC) are poorly investigated. This retrospective study aims at investigating the pancreatic enzyme replacement therapy (PERT) use and its impact on survival and maldigestion-related symptoms in advanced PDAC patients undergoing chemotherapy.
METHODS
A retrospective analysis was conducted on advanced PDAC patients, treated with first-line gemcitabine plus -paclitaxel at two academic institutions (March 2015-October 2018). Data were correlated with overall survival (OS) using Cox regression model. Kaplan-Meier curves were compared using Log-Rank test.
RESULTS
Data from 110 patients were gathered. PERT was administered in 55 patients (50%). No significant differences in baseline characteristics with those who did not receive PERT were found. Median OS for the entire group was 12 months (95% CI 9-15). At multivariate analysis, previous surgical resection of the primary tumor, (HR 2.67, ), weight gain after 3 months (HR 1.68, ) and PERT (HR 2.85, ) were independent predictors of OS. Patients who received PERT reported an improvement of maldigestion-related symptoms at 3 months more frequently than patients who did not (85.2% vs 14.8%, ).
CONCLUSION
PERT is associated with significantly prolonged survival and maldigestion-related symptoms alleviation in advanced PDAC patients.
背景
胰腺外分泌功能不全在晚期胰腺导管腺癌（PDAC）中的临床后果及其治疗方法尚未得到充分研究。这项回顾性研究旨在调查晚期PDAC化疗患者中胰酶替代疗法（PERT）的使用情况及其对生存和消化功能不良相关症状的影响。
方法
对在两个学术机构接受一线吉西他滨加紫杉醇治疗的晚期PDAC患者进行回顾性分析（2015年3月至2018年10月）。使用Cox回归模型将数据与总生存期（OS）相关联。使用对数秩检验比较Kaplan-Meier曲线。
结果
收集了110例患者的数据。55例患者（50%）接受了PERT治疗。未发现与未接受PERT治疗的患者在基线特征上有显著差异。整个组的中位OS为12个月（95%CI 9-15）。在多变量分析中，原发肿瘤既往手术切除（HR 2.67）、3个月后体重增加（HR 1.68）和PERT（HR 2.85）是OS的独立预测因素。接受PERT治疗的患者在3个月时报告消化功能不良相关症状改善的频率高于未接受PERT治疗的患者（85.2%对14.8%）。
结论
PERT与晚期PDAC患者的生存期显著延长和消化功能不良相关症状缓解有关。
Zotero 插件