Retrospective analysis of fixed dose rate infusion of gemcitabine and S-1 combination therapy (FGS) as salvage chemotherapy in patients with gemcitabine-refractory advanced pancreatic cancer: inflammation-based prognostic score predicts survival
Retrospective analysis of fixed dose rate infusion of gemcitabine and S-1 combination therapy (FGS) as salvage chemotherapy in patients with gemcitabine-refractory advanced pancreatic cancer: inflammation-based prognostic score predicts survival
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DOI：
10.1007/s00280-014-2665-8
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发表时间：
2015-03-01
影响因子：
3
通讯作者：
Furuse, Junji
中科院分区：
文献类型：
--
作者：
Kasuga, Akiyoshi;Okano, Naohiro;Furuse, Junji
本研究的目的是评估固定剂量率输注吉西他滨和S-1联合治疗（FGS）在吉西他滨（GEM）难治性胰腺癌（PC）患者中的疗效和安全性，并探讨与生存相关的独立变量。我们回顾性分析了2009年3月至2013年12月在我们机构接受FGS的GEM难治性PC患者。GEM在第1天通过固定剂量率静脉输注1，200 mg/m2（120分钟输注）给药，S-1在第1-7天以40 mg/m2的剂量口服给药，每日两次。61例GEM难治性PC患者接受FGS治疗。16例患者接受FGS作为三线治疗。29例患者（48%）有S-1给药史。客观反应率为13%，疾病控制率为49%。中位无进展生存期为2.7个月，中位总生存期为6.0个月。主要的3级或4级不良事件包括中性粒细胞减少症（15%）、腹泻（3%）、厌食（2%）和疲劳（2%）。高炎症预后评分（改良格拉斯哥预后评分（mGPS），包括C-反应蛋白和白蛋白）、体力状态> 0和血清碳水化合物抗原19-9水平> 2，000 IU/ml与不良预后独立相关。基于炎症的预后评分是挽救化疗环境中生存的简单可靠指标。
The purpose of this study was to assess the efficacy and safety of fixed dose rate infusion of gemcitabine and S-1 combination therapy (FGS) in patients with gemcitabine (GEM)-refractory pancreatic cancer (PC) and to explore independent variables associated with survival.We retrospectively reviewed consecutive patients with GEM-refractory PC who received FGS at our institution from March 2009 to December 2013. GEM was administered by fixed dose rate intravenous infusion of 1,200 mg/m(2) as a 120-min infusion on day 1, and S-1 was administered orally twice a day at a dose of 40 mg/m(2) on days 1-7. Cycles were repeated every 14 days.Sixty-one patients with GEM-refractory PC received FGS. Sixteen patients received FGS as third-line treatment. Twenty-nine patients (48 %) had a history of S-1 administration. The objective response rate was 13 %, and the disease control rate was 49 %. The median progression-free survival time was 2.7 months, and the median overall survival time was 6.0 months. Major Grade 3 or 4 adverse events included neutropenia (15 %), diarrhea (3 %), anorexia (2 %), and fatigue (2 %). A high inflammation-based prognostic score (modified Glasgow prognostic score (mGPS), which incorporates C-reactive protein and albumin), a performance status > 0, and serum carbohydrate antigen 19-9 level > 2,000 IU/ml were independently associated with a poor outcome.FGS might be effective and well tolerated as salvage chemotherapy in a practical setting. The inflammation-based prognostic score is a simple and reliable indicator of survival in the setting of salvage chemotherapy.