脆弱对胰腺癌患者接受新辅助疗法的结果的影响
Nicholas R Williams1, Thomas Leuschner1, Amanda K Walsh1
1Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
虚弱显著影响胰腺癌患者接受新辅助疗法 (NT) 的结果. 脆弱的患者不太可能接受手术,生存率更差,这凸显了在治疗期间改善身体健康的干预措施的必要性.
科学领域:
- 在瘤学瘤学.
- 老年病的医生 老年病的医生
- 手术瘤学手术瘤学
背景情况:
- 新辅助疗法 (NT) 是局部胰腺管腺癌 (PDAC) 的标准.
- 与治疗相关的毒性可以防止手术切除,但这种磨损的危险因素尚不清楚.
- 基线脆弱性对接受NT的PDAC患者的结果的影响需要进行调查.
研究的目的:
- 评估在接受NT的PDAC患者的基线脆弱性和手术切除率之间的关联.
- 评估脆弱对其他次要终点的影响,包括整体存活率.
- 探索功能脆弱性评估与治疗结果之间的关系.
主要方法:
- 对252名潜在切除性 (PR) 或边缘切除性 (BR) PDAC患者接受NT (2019-2025) 的回顾性分析.
- 使用修改的11项脆弱指数 (mFI-11) 评估脆弱性.
- 多变量分析检查了脆弱性,人口统计,治疗和结果 (切除,生存) 之间的关联. 功能性评估在一个子集中被前性地获得.
主要成果:
- 5.2%的患者通过mFI-11被归类为脆弱.
- 脆弱的患者表现出更糟糕的表现状态和更多的并发症.
- 脆弱性 (OR 0.09) 独立预测了切除的几率降低,并与较差的整体存活率 (HR 3.00) 相联系.
- 在39名具有功能评估的患者中,只有异常姿势与较低的切除几率 (OR 0.22) 相相关.
结论:
- 基线脆弱性,特别是通过mFI-11测量,是局部PDAC患者进行NT的手术切除率降低和整体存活率降低的重要预测因素.
- 功能性脆弱性评估在这个队列中为切除或生存提供了有限的预测价值.
- 未来的研究应该优先考虑在PDAC新辅助治疗期间增强功能状态的干预措施,以改善治疗结果.
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