Abstract：
Background: The follow-up of pancreatic cancer (PC) is based on computed tomography (CT) assessment; however, there is no consensus on the use of clinical and biological criteria in tumor progression. We aimed to establish a clinical−biological model to highlight the progression of metastatic PC during first-line treatment. Methods: The patients treated with first-line chemotherapy in the phase 2/3 PRODIGE4/ACCORD11 clinical trial were evaluated retrospectively. Clinical and biological markers were evaluated at the time of CT scans and during treatment to determine tumor progression. Results: In total, 196 patients were analyzed, with 355 available tumor assessments. The clinical and biological factors associated with tumor progression in multivariate analysis included gemcitabine, global health status ≤ 33 (OR = 3.38, 95%CI [1.15; 9.91], p = 0.028), quality of life score between 34 and 66 (OR = 2.65, 95%CI [1.06; 6.59], p = 0.037), carcinoembryonic antigen (CEA) ≥ 3 times the standard value without any increase in the CEA level from inclusion (OR = 2.22, 95%CI [1.01; 4.89], p = 0.048) and with an increase in the CEA level from inclusion (OR = 6.56, 95%CI [2.73; 15.78], p < 0.001), and an increase in the carbohydrate antigen 19-9 level from inclusion (OR = 2.59, 95%CI [1.25; 5.36], p = 0.016). Conclusions: The self-assessment of patients’ general health status alongside tumor markers is an interesting approach to the diagnosis of the tumor progression of metastatic pancreatic cancer patients during first-line treatment.
摘要：
背景：胰腺癌（PC）的随访基于计算机断层扫描（CT）评估；但是，在肿瘤进展中使用临床和生物学标准方面尚无共识.我们旨在建立临床生物学模型，以突出一线治疗期间转移性PC的进展。
方法：对在2/3期PRODIGE4/ACCORD11临床试验中接受一线化疗的患者进行回顾性评估。在CT扫描时和治疗期间评估临床和生物学标志物以确定肿瘤进展。
结果：总计，196例患者进行了分析，355个可用的肿瘤评估。多变量分析中与肿瘤进展相关的临床和生物学因素包括吉西他滨，全球健康状况≤33(OR=3.38，95CI[1.15；9.91]，p=0.028),生活质量评分在34至66之间(OR=2.65,95CI[1.06;6.59]，p=0.037),癌胚抗原（CEA）≥标准值的3倍，而纳入后CEA水平没有任何增加（OR=2.22，95CI[1.01;4.89]，p=0.048），并且随着纳入CEA水平的增加（OR=6.56，95CI[2.73；15.78]，p<0.001)，和碳水化合物抗原19-9水平的增加（OR=2.59，95CI[1.25;5.36]，p=0.016)。
结论：与肿瘤标志物一起对患者的一般健康状况进行自我评估是诊断一线治疗期间转移性胰腺癌患者肿瘤进展的一种有趣的方法。
方法：对在2/3期PRODIGE4/ACCORD11临床试验中接受一线化疗的患者进行回顾性评估。在CT扫描时和治疗期间评估临床和生物学标志物以确定肿瘤进展。
结果：总计，196例患者进行了分析，355个可用的肿瘤评估。多变量分析中与肿瘤进展相关的临床和生物学因素包括吉西他滨，全球健康状况≤33(OR=3.38，95CI[1.15；9.91]，p=0.028),生活质量评分在34至66之间(OR=2.65,95CI[1.06;6.59]，p=0.037),癌胚抗原（CEA）≥标准值的3倍，而纳入后CEA水平没有任何增加（OR=2.22，95CI[1.01;4.89]，p=0.048），并且随着纳入CEA水平的增加（OR=6.56，95CI[2.73；15.78]，p<0.001)，和碳水化合物抗原19-9水平的增加（OR=2.59，95CI[1.25;5.36]，p=0.016)。
结论：与肿瘤标志物一起对患者的一般健康状况进行自我评估是诊断一线治疗期间转移性胰腺癌患者肿瘤进展的一种有趣的方法。
