Chen Yen-Yang, Hsueh Shun-Wen, Yang Shih-Hung, Chiu Sz-Chi, Chiang Nai-Jung, Chiu Tai-Jan, Li Chung-Pin, Bai Li-Yuan, Chiu Chang-Fang, Chuang Shih-Chang, Shan Yan-Shen, Chan De-Chuan, Chen Li-Tzong, Yen Chia-Jui, Peng Cheng-Ming, Chen Jen-Shi, Chou Wen-Chi
Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University Kaohsiung, Taiwan.
Division of Hematology-Oncology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital and Chang Gung University Taoyuan, Taiwan.
Am J Cancer Res. 2022 Sep 15;12(9):4267-4278. eCollection 2022.
Liposomal irinotecan plus 5-fluorouracil and leucovorin (nal-IRI + 5-FU/LV) treatment has demonstrated survival benefits but noticeable side effects in patients with pancreatic ductal adenocarcinoma (PDAC) that is refractory to gemcitabine-based therapy. This study aimed to explore whether combining albumin with the neutrophil-to-lymphocyte ratio (NLR), herein known as the albumin and neutrophil-to-lymphocyte ratio score (ANS), could be utilized as a simple tool to predict survival and safety profiles in such patient groups. We retrospectively enrolled 434 consecutive PDAC patients treated with nal-IRI + 5-FU/LV between 2018 and 2020 at nine medical centers in Taiwan. Patients were divided into three groups: ANS 0 (high albumin and low NLR), ANS 1 (low albumin or high NLR), and ANS 2 (low albumin and high NLR), for comparison. The median overall survival times for the ANS 0, 1, and 2 groups were 8.7 months (95% confidence interval (CI), 7.0-10.3 months), 5.2 months (95% CI, 4.3-6.0 months), and 2.6 months (95% CI, 1.9-3.3 months), respectively. The ANS was found to be an independent variable for overall survival and time-to-treatment failure in multivariate analyses. Patients in the ANS 2 group had significantly higher incidences of grade 3 or higher treatment-related adverse events than those in the other two groups. The present study showed that the ANS was an independent prognosticator in PDAC patients receiving nal-IRI + 5-FU/LV therapy. The ANS can be a simple predictor of survival outcome and safety profiles in PDAC patients treated with nal-IRI + 5-FU/LV.
脂质体伊立替康联合5-氟尿嘧啶和亚叶酸钙（nal-IRI + 5-FU/LV）治疗已显示出对吉西他滨为基础的治疗难治的胰腺导管腺癌（PDAC）患者有生存获益，但存在明显副作用。本研究旨在探讨将白蛋白与中性粒细胞与淋巴细胞比值（NLR）相结合，即本文所称的白蛋白和中性粒细胞与淋巴细胞比值评分（ANS），是否可作为预测此类患者群体生存和安全性的简单工具。我们回顾性纳入了2018年至2020年期间在台湾九个医疗中心接受nal-IRI + 5-FU/LV治疗的434例连续PDAC患者。患者分为三组：ANS 0（高白蛋白和低NLR）、ANS 1（低白蛋白或高NLR）和ANS 2（低白蛋白和高NLR），以进行比较。ANS 0、1和2组的中位总生存时间分别为8.7个月（95%置信区间（CI），7.0 - 10.3个月）、5.2个月（95% CI，4.3 - 6.0个月）和2.6个月（95% CI，1.9 - 3.3个月）。在多变量分析中，ANS被发现是总生存和治疗失败时间的独立变量。ANS 2组3级或更高等级治疗相关不良事件的发生率显著高于其他两组。本研究表明，ANS是接受nal-IRI + 5-FU/LV治疗的PDAC患者的独立预后指标。ANS可作为接受nal-IRI + 5-FU/LV治疗的PDAC患者生存结局和安全性的简单预测指标。
