小肠神经内分泌肿瘤按治疗方案的生存率

Survival According to Therapy Regimen for Small Intestinal Neuroendocrine Tumors.

作者信息

Koch Christine, Bambey Cornelia, Filmann Natalie, Stanke Marc, Waidmann Oliver, Husmann Gabriele, Bojunga Joerg

机构信息

Department of Gastroenterology, Hepatology and Endocrinology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt, Germany.

Department of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, 60590 Frankfurt, Germany.

出版信息

J Clin Med. 2022 Apr 22;11(9):2358. doi: 10.3390/jcm11092358.

INTRODUCTION

Scarce data exist for therapy regimens other than somatostatin analogues (SSA) and peptide receptor radiotherapy (PRRT) for siNET. We analyzed real world data for differences in survival according to therapy.

PATIENTS AND METHODS

Analysis of 145 patients, diagnosed between 1993 and 2018 at a single institution, divided in treatment groups. Group (gr.) 0: no treatment ( = 10), gr 1: TACE and/or PRRT ( = 26), gr. 2: SSA ( = 32), gr. 3: SSA/PRRT ( = 8), gr. 4: chemotherapy ( = 8), gr. 5: not metastasized (at diagnosis), surgery only ( = 53), gr. 6 = metastasized (at diagnosis), surgery only ( = 10).

RESULTS

45.5% female, median age 60 years (range, 27-84). A total of 125/145 patients with a resection of the primary tumor. For all patients, 1-year OS (%) was 93.8 (95%-CI: 90-98), 3-year OS = 84.3 (CI: 78-90) and 5-year OS = 77.5 (CI: 70-85). For analysis of survival according to therapy, only stage IV patients (baseline) that received treatment were included. Compared with reference gr. 2 (SSA only), HR for OS was 1.49 ( = 0.47) for gr. 1, 0.72 ( = 0.69) for gr. 3, 2.34 ( = 0.19) for gr. 4. The 5 y OS rate of patients whose primary tumor was resected ( = 125) was 73.1%, and without PTR was 33.3% (HR: 4.31; = 0.003). Individual patients are represented in swimmer plots.

CONCLUSIONS

For stage IV patients in this analysis (limited by low patient numbers in co. 3/4), multimodal treatment did not significantly improve survival over SSA treatment alone. A resection of primary tumor significantly improves survival.

引言

关于生长抑素类似物（SSA）和肽受体放射性核素治疗（PRRT）以外的治疗方案用于胃肠胰神经内分泌肿瘤（siNET）的数据稀缺。我们分析了实际数据，以了解不同治疗方法在生存方面的差异。

患者与方法

对1993年至2018年在单一机构确诊的145例患者进行分析，将其分为治疗组。第0组：未治疗（n = 10），第1组：经动脉化疗栓塞（TACE）和/或PRRT（n = 26），第2组：SSA（n = 32），第3组：SSA/PRRT（n = 8），第4组：化疗（n = 8），第5组：（诊断时）未发生转移，仅接受手术治疗（n = 53），第6组：（诊断时）已发生转移，仅接受手术治疗（n = 10）。

结果

45.5%为女性，中位年龄60岁（范围27 - 84岁）。共有125/145例患者接受了原发肿瘤切除术。所有患者的1年总生存率（%）为93.8（95%置信区间：90 - 98），3年总生存率 = 84.3（置信区间：78 - 90），5年总生存率 = 77.5（置信区间：70 - 85）。为分析不同治疗方法的生存情况，仅纳入了接受治疗的IV期患者（基线）。与参照组2（仅接受SSA治疗）相比，第1组的总生存风险比（HR）为1.49（p = 0.47），第3组为0.72（p = 0.69），第4组为2.34（p = 0.19）。原发肿瘤接受切除的患者（n = 125）的5年总生存率为73.1%，未接受切除的患者为33.3%（HR：4.31；p = 0.003）。个体患者情况以泳者图表示。