Predictive value of dynamic change of haemoglobin levels during therapy on treatment outcomes in patients with Enneking stage IIB extremity osteosarcoma.
Predictive value of dynamic change of haemoglobin levels during therapy on treatment outcomes in patients with Enneking stage IIB extremity osteosarcoma.
复制标题
治疗期间血红蛋白水平动态变化对Enneking IIB期肢体骨肉瘤患者治疗结果的预测价值。
DOI：
10.1186/s12885-018-4279-8
复制
发表时间：
2018-04-16
期刊：
影响因子：
3.8
通讯作者：
Shen J
中科院分区：
文献类型：
--
作者：
Tu J;Wen L;Huo Z;Wang B;Wang Y;Liao H;Liu W;Zhong X;Kong J;Wang M;Huang G;Yin J;Xie X;Shen J
目的探讨血红蛋白（Hb）浓度及其在治疗过程中的动态变化对肢体骨肉瘤患者预后的影响。我们回顾性分析了133例接受标准治疗的Enneking IIB期肢体骨肉瘤患者，包括患者特征、预治疗、新辅助化疗、辅助化疗期间Hb浓度和变化以及Hb水平降低（Δ Hb）的单变量和多变量分析，以评估其5年总生存率（OS）和无肺转移生存率（LMFS）的预后价值。在治疗前、新辅助或辅助化疗期间贫血和非贫血患者之间的5年OS或LMFS相似。Hb持续下降的患者5年OS（52.3%）低于Hb无持续下降的患者（68.5%，P = 0.04）。Δ Hb> 7.6 g/L患者的5年OS（57.5%）低于Δ Hb ≤ 7.6 g/L患者（75.8%）（P = 0.04）。然而，持续Hb下降对5年LMFS无预后影响。亚组分析显示，在预处理、新辅助或辅助化疗期间贫血且Δ Hb ≤ 7.6 g/L的患者的结局优于Δ Hb> 7.6 g/L的患者（P <0.05，均为P <0.05）。Enneking IIB期肢体骨肉瘤患者动态Hb降低和Δ Hb> 7.6预测5年OS较差纠正贫血的尝试及其对骨肉瘤患者结局的影响应在未来的试验中进行研究。
We aimed to investigate the roles of hemoglobin (Hb) concentrations and dynamic change during treatment on outcomes of patients with extremity osteosarcoma. We retrospectively analysed 133 patients with Enneking stage IIB extremity osteosarcoma who underwent standard treatments, including univariate and multivariate analyses of patient charateritics, Hb concentrations and changes during pretreatment, neoadjuvant, adjuvant chemotherapy, and decreased Hb levels (ΔHb) to assess their prognostic value in 5-year overall survival (OS) and lung metastasis-free survival (LMFS). Five-year OS or LMFS were similar between patients who were anaemic and non-anaemic during pretreatment, neoadjuvant or adjuvant chemotherapy. Patients with continuously decreasing Hb had lower 5-year OS (52.3%) than those without continuous Hb decrease (68.5%, P = 0.04). Patients with ΔHb > 7.6 g/L had lower 5-year OS (57.5%) than those with ΔHb ≤7.6 g/L (75.8%, P = 0.04). However, continuous Hb decrease had no prognostic effect on 5-year LMFS. Subgroup analyses showed that patients who were anaemic during pretreatment, neoadjuvant, or adjuvant chemotherapy with ΔHb ≤7.6 g/L had better outcomes than those with ΔHb > 7.6 g/L (P < 0.05, for both). Dynamic Hb decrease and ΔHb > 7.6 predicted poor5-year OS in patients with Enneking stage IIB extremity osteosarcoma. Attempts to correct anaemia and their effects on outcomes for osteosarcoma patients should be investigated in future trials.