A prognostic model in patients treated for metastatic gastric cancer with second-line chemotherapy
A prognostic model in patients treated for metastatic gastric cancer with second-line chemotherapy
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DOI：
10.1093/annonc/mdq032
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发表时间：
2010-09-01
影响因子：
50.5
通讯作者：
Tjulandin, S. A.
中科院分区：
文献类型：
--
作者：
Kanagavel, D.;Pokataev, I. A.;Tjulandin, S. A.
背景资料：本回顾性研究旨在评估二线化疗治疗转移性胃癌患者的临床因素的预后意义。Patients and Methods：我们评估了126例二线化疗患者的各种临床因素的预后意义。二线化疗的中位无进展生存期和总生存期（OS）分别为3.3和5.3个月，总缓解率为11.1%。多变量分析确定了三个独立的预后因素：体力状态：东部肿瘤协作组0至1 [风险比（HR）2.3，95%置信区间（CI）1.7-5.4]，血红蛋白（Hb）水平：>= 10 g/dl（HR 2.2，95% CI 2.1-2.4）和一线治疗下的至进展时间（TTP）：>= 5个月（HR 0.5，95% CI 0.3-0.8）。根据获得的数据，构建了预后指数，将患者分为三个风险组：良好（n = 40），中度（n = 36）和不良风险组（n = 56）。好、中、差风险组的中位生存期分别为13.5、6.0和2.9个月，而1年OS率分别为50.2%、14.2%和2.6（P = 0.00001）。结论：由于目前随机对照试验的数据不足，我们的报告表明，二线化疗是有效的和有益的患者良好的性能状态，较高的Hb水平沿着较高的TTP在一线治疗。
Background: This retrospective study was carried out to evaluate the prognostic significance of clinical factors in patients treated for metastatic gastric cancer with second-line chemotherapy.Patients and methods: We evaluated the prognostic significance of various clinical factors in 126 patients, who were treated with second-line chemotherapy.Results: Median progression-free and overall survival (OS) for second-line chemotherapy were 3.3 and 5.3 months, respectively, with an overall response rate of 11.1%. Multivariate analysis identified three independent prognostic factors: performance status: Eastern Cooperative Oncology Group zero to one [hazard ratio (HR) 2.3, 95% confidence interval (CI) 1.7-5.4], hemoglobin (Hb) level: >= 10 g/dl (HR 2.2, 95% CI 2.1-2.4) and time-to-progression (TTP) under first-line therapy: >= 5 months (HR 0.5, 95% CI 0.3-0.8). From the obtained data, a prognostic index was constructed, dividing the patients into three risk groups: good (n = 40), intermediate (n = 36) and poor risk group (n = 56). The median survival for good, intermediate and poor risk groups were 13.5, 6.0 and 2.9 months, respectively, whereas the 1-year OS rates were 50.2%, 14.2% and 2.6%, respectively (P = 0.00001).Conclusions: With inadequate data from randomized controlled trials at the moment, our report indicates that second-line chemotherapy is effective and beneficial in patients with good performance status, higher Hb level along with higher TTP under first-line therapy.