摘要
目的探讨早期肿瘤退缩(ETS)和肿瘤反应深度(DpR)与曲妥珠单抗联合化疗一线治疗人表皮生长因子受体2(HER-2)阳性晚期胃癌患者的疗效及预后的关系。方法回顾性分析2008年1月1日至2017年12月31日间就诊于浙江大学医学院附属第二医院的23例组织学明确为胃腺癌、影像学证实为转移性胃癌患者的临床病理资料。采用Kaplan-Meier法和Log rank检验进行生存分析,采用Cox回归分析对可能影响患者预后的因素进行分析。结果23例患者中,客观有效率为43.5%,疾病控制率为82.6%。单因素分析显示,ETS≥20%和ETS<20%患者的中位无进展生存时间(PFS)分别为13.0和4.5个月,差异有统计学意义(P<0.001);ETS≥20%和ETS<20%患者中位总生存时间(OS)分别为26.8和10.1个月,差异有统计学意义(P<0.001)。DpR≥15%和DpR<15%患者的中位PFS分别为13.0和4.5个月,差异有统计学意义(P=0.001);DpR≥15%和DpR<15%患者的中位OS分别为26.8和9.5个月,差异有统计学意义(P<0.001)。多因素分析显示,ETS为影响患者PFS的独立因素(P=0.030),肿瘤部位和美国东部肿瘤协作组评分为影响患者OS的独立因素(均P<0.05)。结论ETS和DpR可能有效预测曲妥珠单抗联合化疗一线治疗HER-2阳性晚期胃癌的疗效和预后。
Objective To explore the relationship of early tumor shrinkage(ETS)and depth of response(DpR)with the prognosis and treatment effect of trastuzumab combined with chemotherapy as first-line treatment in advanced gastric cancer with epidermal growth factor receptor 2(HER-2)positive.Methods We retrospectively analyzed the clinical and pathological data of 23 patients with metastatic gastric adenocarcinoma diagnosed by imaging in The Second Affiliated Hospital of Zhejiang University School of Medicine from January 1st,2008 to December 31th,2017.Kaplan-Meier method and the log-rank test were used for the survival analysis.Cox regression was used to analyze the factors associated with prognosis.Results The objective response rate(ORR)of the 23 patients was 43.5%and the disease control rate(DCR)was 82.6%.Univariate analysis showed the median progress-free survival(mPFS)of ETS≥20%and ETS<20%were 13.0 months and 4.5 months,respectively,with statistical significance(P<0.001).The median overall survival(mOS)of ETS≥20%and ETS<20%were 26.8 months and 10.1 months,respectively,with statistical significance(P<0.001).The median progress-free survival(mPFS)of DpR≥15%and DpR<15%were 13.0 months and 4.5 months,respectively,with statistical significance(P=0.001).The median overall survival(mOS)of DpR≥15%and DpR<15%were 26.8 months and 9.5 months,respectively,with statistical significance(P<0.001).Multivariable Cox regression analysis revealed ETS was an independent factor of PFS(P=0.030),tumor site and Eastern Cooperative Oncology Group(ECOG)score were independent factors of OS(P<0.05).Conclusion ETS and DpR might be used to predict the treatment efficacy and prognosis of trastuzumab combined with chemotherapy as the first-line treatment of HER-2 positive gastric cancer.
作者
朱柠
陈佳琦
杨梦园
程怡
袁瑛
Zhu Ning;Chen Jiaqi;Yang Mengyuan;Cheng Yi;Yuan Ying(Department of Medical Oncology,Key Laboratory of Cancer Prevention and Intervention Ministry of Education,The Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China)
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2020年第10期869-875,共7页
Chinese Journal of Oncology
关键词
胃肿瘤
早期肿瘤退缩
肿瘤反应深度
曲妥珠单抗
预后
Gastric neoplasms
Early tumor shrinkage
Depth of response
Trastuzumab
Prognosis
