早期肿瘤退缩与白蛋白紫杉醇联合吉西他滨一线治疗晚期胰腺癌效果及预后的关系

Relationship of efficacy and prognosis between early tumor shrinkage and albumin paclitaxel combined with gemcitabine in the first-line treatment of advanced pancreatic cancer

目的探讨早期肿瘤退缩(ETS)与白蛋白紫杉醇联合吉西他滨(AG方案)一线治疗晚期胰腺癌效果及预后的关系。方法回顾性分析2018年1月至2023年1月期间就诊于绍兴市中心医院的38例晚期胰腺癌患者的临床资料,利用受试者工作特征(ROC)曲线分析ETS最佳临界值,采用Kaplan-Meier法和Log-rank检验进行生存分析,采用Cox回归分析ETS与晚期胰腺癌预后的关系。结果38例晚期胰腺癌患者的中位无进展生存期(PFS)为6.20(95%CI 5.90-6.50)个月,中位总生存期(OS)为12.00(95%CI 9.74-14.27)个月,疾病控制率(DCR)为82.6%,ETS最佳临界值为9.25%,ETS≥9.25%的患者(n=17)较ETS<9.25%的患者(n=21)具有更长的PFS(8.00个月vs 4.80个月,P<0.05)及OS(16.50个月vs 10.20个月,P<0.05)。Cox回归分析显示ETS为影响晚期胰腺癌患者生存预后的独立因素(PFS:HR=0.341,95%CI0.135-0.860,P<0.05;OS:HR=0.225,95%CI 0.084-0.603)。结论AG方案一线治疗晚期胰腺癌疗效尚可,ETS可有效预测AG方案一线治疗晚期胰腺癌的效果和预后。

Objective To explore the relationship of efficacy and prognosis between early tumor shrinkage(ETS)and albumin paclitaxel combined with gemcitabine(AG regimen)in the first-line treatment of advanced pancreatic cancer.Methods A retrospective analysis was conducted on 38 advanced pancreatic cancer patients in Shaoxing Central Hospital from Jan.2018 to Jan.2023.The optimum critical value of ETS was analyzed by receiver operating characteristic(ROC)curve.Survival analysis was conducted by Kaplan-Meier method and Log-rank test,and the relationship between ETS and the prognosis of advanced pancreatic cancer was analyzed by Cox regression.Results For the 38 advanced pacreatic patients,the median progression-free survival(PFS)was 6.20(95%CI 5.90-6.50)months,the median overall survival(OS)was 12.00(95%CI 9.74-14.27)months,the disease control rate(DCR)was 82.6%,and the best critical value of ETS was 9.25%.The patients with ETS≥9.25%(n=17)had longer PFS(8.00 months vs 4.80 months,P<0.05)and OS(16.50 months vs 10.20 months,P<0.05)than those with ETS<9.25%(n=21).Cox multivariate regression analysis showed that ETS was an independent factor affecting the survival and prognosis of advanced pancreatic cancer(PFS:HR=0.341,95%CI 0.135-0.680,P<0.05;OS:HR=0.225,95%CI 0.084-0.603,P<0.05).Conclusion The AG regimen is effective in the first-line treatment of advanced pancreatic cancer.ETS can effectively predict the efficacy and prognosis of advanced pancreatic cancer with AG regimen.