再発および切除不能膵がん患者における化学療法中止基準としての栄養・免疫・炎症指標の有用性の検討

  • 中井 將人
    地方独立行政法人 広島市立病院機構 広島市立広島市民病院 薬剤部
  • 吉川 明良
    地方独立行政法人 広島市立病院機構 広島市立広島市民病院 薬剤部
  • 舟原 宏子
    地方独立行政法人 広島市立病院機構 広島市立広島市民病院 薬剤部
  • 開 浩一
    地方独立行政法人 広島市立病院機構 広島市立広島市民病院 薬剤部

書誌事項

タイトル別名
  • Usefulness of Nutrition, Immunity, and Inflammation Indices as Criteria for Chemotherapy Discontinuation in Patients with Relapsed and Unresectable Pancreatic Cancer

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説明

<p>The criteria for palliative chemotherapy discontinuation have not been adequately systematized. We evaluated the relevance of the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, prognostic nutritional index, modified Glasgow Prognostic Score (mGPS), and clinicopathological factors as potential factors for chemotherapy discontinuation in patients with recurrent and unresectable pancreatic cancer.</p><p>We retrospectively analyzed the data of 91 patients who received palliative chemotherapy for recurrent and unresectable pancreatic cancer at Hiroshima City Hospital between April 2014 and March 2018. Factors significantly related to chemotherapy discontinuation were extracted using Coxʼs proportional-hazard model, and a prognostic model was established by combining these factors.</p><p>The median overall survival was 76 days. Multivariate analysis of the factors revealed that the mGPS (0/1-2) (hazard ratio [HR] = 3.053, P = 0.005), the presence of distant metastatic disease (HR = 2.605, P < 0.001), and the status of recurrent or initially unresectable disease (HR = 2.587, P = 0.013) were significantly associated with the discontinuation decision. One point was assigned to each of these three factors to create the prognostic model. A total score index of 0-3 was used to categorize three prognostic risk groups. The high-risk group (3 points) had a significantly lower overall survival than the low- (≤1 point) (P < 0.001) and intermediate-risk (2 points) groups (P < 0.001).</p><p>Our study shows that mGPS and this prognostic model can help determine whether chemotherapy should be discontinued in patients with relapsed and unresectable pancreatic cancer.</p>

収録刊行物

  • 医療薬学

    医療薬学 47 (6), 307-315, 2021-06-10

    一般社団法人日本医療薬学会

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