Systemic Chemotherapy With or Without Hepatic Arterial Infusion Chemotherapy for Liver Metastases From Pancreatic Cancer: A Propensity Score Matching Analysis

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical colorectal cancer Pub Date : 2023-03-01 DOI:10.1016/j.clcc.2022.10.007

Huaqiang Ouyang , Weidong Ma , Tongguo Si , Donglin Liu , Ping Chen , Anna Sandström Gerdtsson , Jiahong Song , Yue Ni , Juanjuan Luo , Zhuchen Yan

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引用次数: 0

Abstract

Background

The significance of systemic chemotherapy (SCT) combined with hepatic arterial infusion (HAI) chemotherapy in the treatment of pancreatic ductal adenocarcinoma with liver metastases (PACLM) remains unclear. Based on previous studies, this single-center propensity score matching (PSM) study aimed to explore the efficacy of SCT with or without HAI for PACLM.

Patient and Methods

The PSM method was used to screen 661 cases of PACLM who received SCT at Tianjin Medical University Cancer Institute and Hospital from 2001 to 2020. According to the 1:6 ratio with PSM, 385 patients were divided into the SCT+HAI group (n = 55) and the SCT group (n = 330). After a median follow-up of 49 (range 7-153) months, overall survival (OS) and survival-related prognostic factors were analyzed.

Results

The main baseline characteristics of the SCT+HAI group and the SCT alone group were matched appropriately (P > .05). After PSM, the median OS for patients in the 2 groups was 10.6 and 7.6 months, respectively (P = .02). Multivariate analysis revealed that peritoneal metastases (P = .03), CA199 ≥ 500U/mL (P = .03), and lactate dehydrogenase (LDH) ≥ 250U/L (P = .03) were prognostic factors of poor survival, modern SCT plus HAI (P = .04) was a protective factor.

Conclusion

Our findings indicated that adequate cycles of SCT+HAI result in better survival than SCT alone in patients with PACLM. Patients with peritoneal metastases, markedly elevated CA19-9 and LDH have a poorer prognosis. The conclusion has yet to be validated in randomized controlled clinical trials.

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癌症肝转移患者肝动脉灌注化疗与不灌注化疗的倾向性评分匹配分析

背景系统化疗（SCT）联合肝动脉灌注化疗（HAI）在治疗胰腺导管腺癌伴肝转移（PACLM）中的意义尚不清楚。在以往研究的基础上，本研究旨在探讨有或无HAI的螺旋CT治疗PACLM的疗效。患者和方法采用PSM方法对2001-2020年在天津医科大学癌症研究所和医院接受螺旋CT治疗的661例PACLM患者进行筛查。根据PSM 1:6的比例，385例患者被分为SCT+HAI组（n=55）和SCT组（n=330）。中位随访49个月（7-153个月）后，分析总生存率（OS）和生存相关的预后因素。结果SCT+HAI组和单独SCT组的主要基线特征匹配良好（P>；.05）。PSM后，两组患者的中位OS分别为10.6和7.6个月（P=.02）。多因素分析显示腹膜转移（P=.03）、CA199≥500U/mL，乳酸脱氢酶（LDH）≥250U/L（P=0.03）是预后不良的因素，现代SCT加HAI（P=0.04）是一个保护因素。结论我们的研究结果表明，在PACLM患者中，适当的SCT+HAI周期比单独的SCT能获得更好的生存率。腹膜转移、CA19-9和LDH显著升高的患者预后较差。这一结论尚未在随机对照临床试验中得到验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical colorectal cancer 医学-肿瘤学

CiteScore

5.50

自引率

2.90%

发文量

审稿时长

27 days

期刊介绍： Clinical Colorectal Cancer is a peer-reviewed, quarterly journal that publishes original articles describing various aspects of clinical and translational research of gastrointestinal cancers. Clinical Colorectal Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of colorectal, pancreatic, liver, and other gastrointestinal cancers. The main emphasis is on recent scientific developments in all areas related to gastrointestinal cancers. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.