Paraneoplastic thrombocytosis independently predicts poor prognosis in patients with locally advanced pancreatic cancer
Paraneoplastic thrombocytosis independently predicts poor prognosis in patients with locally advanced pancreatic cancer
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DOI：
10.3109/0284186x.2014.1000466
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发表时间：
2015-01-01
期刊：
影响因子：
3.1
通讯作者：
Krishnan, Sunil
中科院分区：
文献类型：
--
作者：
Chadha, Awalpreet S.;Kocak-Uzel, Esengul;Krishnan, Sunil
背景和目标。血小板被认为促进肿瘤生长和转移，但其在局部晚期胰腺癌(LAPC)中的预后作用仍很大程度上尚不清楚。我们评估了治疗前血小板计数是否独立预测接受放化疗(CRT)的LAPC患者的生存结果。我们回顾了MD Anderson胰腺癌数据库，确定了2006至2012年间接受CRT治疗的199例LAPC患者。177例(89%)患者在巩固CRT之前先进行诱导化疗。中位剂量为50.4Gy.同时使用的放射增敏剂是吉西他滨(13%)或卡培他滨(84%)方案。采用精算、单变量和多变量统计方法，确定从治疗开始计算的总生存期(OS)和无进展生存期(PFS)的显著预后因素。中位随访时间为9.9个月。中位OS和PFS持续时间分别为17.7个月和10.7个月。单因素分析显示，血小板计数和GT；300K/亩L、KPS=5%体重减轻和治疗前CA19-9高于中位数与OS或PFS下降有关。血小板计数为300K/亩的L患者的中位OS低于血小板计数为300K/亩的患者(P=0.012)、体重下降5%的患者(P=0.002)和治疗前CA19-9升高(P=0.005)是影响OS的独立预后因素。血小板计数300K/亩L(p=0.03)和KPS
Background and aims. Platelets are believed to promote tumor growth and metastasis but their prognostic role in locally advanced pancreatic cancer (LAPC) remains largely unknown. We assessed whether pretreatment platelet counts independently predict survival outcomes in patients with LAPC treated with chemoradiation (CRT).Methods. We retrospectively reviewed the MD Anderson pancreatic cancer database and identified 199 patients with LAPC treated with CRT between 2006 and 2012. Induction chemotherapy was used prior to consolidative CRT in 177 (89%) patients. Median radiation dose was 50.4 Gy. Concurrent radiosensitizers were gemcitabine-based (13%) or capecitabine-based (84%) regimens. Actuarial univariate and multivariate statistical methods were used to determine significant prognostic factors for overall survival (OS) and progression-free survival (PFS) calculated from the start of treatment.Results. Median follow-up was 9.9 months. Median OS and PFS durations were 17.7 and 10.7 months, respectively. On univariate analysis, platelet count >300 K/mu l, KPS = 5% weight loss and pretreatment CA19-9 above the median were associated with inferior OS or PFS. Median OS was lower in patients with platelet count > 300 K/mu l compared to patients with platelet count 300 K/mu l (p = 0.012), >= 5% weight loss (p = 0.002) and elevated pretreatment CA19-9 (p = 0.005) were independent prognostic factors for OS. Platelet count > 300 K/mu l (p = 0.03) and KPS