PDF(Pubmed)
Abstract：
UNASSIGNED: The limited efficacy of chemotherapy in improving survival in pancreatic ductal adenocarcinoma (PDAC) necessitates the exploration of novel strategies to overcome treatment resistance.
UNASSIGNED: This study aimed to investigate the impact of combining renin-angiotensin system (RAS) blockers with chemotherapy on survival outcomes in patients with PDAC.
UNASSIGNED: Patients with PDAC were enrolled in the retrospective study.
UNASSIGNED: We analyzed patients with PDAC (n = 384) at our institution between 2014 and 2021. Survival outcomes, including event-free survival (EFS) and overall survival (OS), were analyzed according to the concomitant use of RAS blockers.
UNASSIGNED: Among the 384 patients in the study, 70 (18.2%) concomitantly received angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). Patients in the ACEI/ARB group, characterized by older age and more comorbidities, displayed a significantly superior 12-month EFS rate (22.86% versus 13.69%, p = 0.008) compared to the non-ACEI/ARB group, while OS remained similar between the groups. In the multivariate analysis, the use of ACEI/ARB was associated with better 12-month EFS (hazards ratio = 0.71, 95% confidence interval: 0.52-0.96; p = 0.024). Poor performance, advanced disease status, and higher CA19-9 levels were associated with poor survival outcomes.
UNASSIGNED: Concomitant use of ACEIs/ARBs in patients with pancreatic cancer resulted in significantly better 12-month EFS. Age, performance status, disease status, and higher CA19-9 levels were independent predictors of survival. The combination strategy might provide better treatment outcomes in patients with PDAC.
UNASSIGNED: This study aimed to investigate the impact of combining renin-angiotensin system (RAS) blockers with chemotherapy on survival outcomes in patients with PDAC.
UNASSIGNED: Patients with PDAC were enrolled in the retrospective study.
UNASSIGNED: We analyzed patients with PDAC (n = 384) at our institution between 2014 and 2021. Survival outcomes, including event-free survival (EFS) and overall survival (OS), were analyzed according to the concomitant use of RAS blockers.
UNASSIGNED: Among the 384 patients in the study, 70 (18.2%) concomitantly received angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). Patients in the ACEI/ARB group, characterized by older age and more comorbidities, displayed a significantly superior 12-month EFS rate (22.86% versus 13.69%, p = 0.008) compared to the non-ACEI/ARB group, while OS remained similar between the groups. In the multivariate analysis, the use of ACEI/ARB was associated with better 12-month EFS (hazards ratio = 0.71, 95% confidence interval: 0.52-0.96; p = 0.024). Poor performance, advanced disease status, and higher CA19-9 levels were associated with poor survival outcomes.
UNASSIGNED: Concomitant use of ACEIs/ARBs in patients with pancreatic cancer resulted in significantly better 12-month EFS. Age, performance status, disease status, and higher CA19-9 levels were independent predictors of survival. The combination strategy might provide better treatment outcomes in patients with PDAC.
摘要：
■化疗在提高胰腺导管腺癌（PDAC）生存率方面的疗效有限，因此需要探索克服治疗耐药性的新策略。
■本研究旨在探讨肾素-血管紧张素系统(RAS)阻滞剂联合化疗对PDAC患者生存结局的影响。
■PDAC患者纳入回顾性研究。
■我们分析了2014年至2021年在我们机构接受PDAC（n=384）的患者。生存结果,包括无事件生存率（EFS）和总生存率（OS），根据RAS阻断剂的伴随使用情况进行分析。
■在研究的384名患者中，70（18.2％）同时接受了血管紧张素转换酶抑制剂（ACEI）和血管紧张素受体阻滞剂（ARB）。ACEI/ARB组患者，特点是年龄较大，合并症较多，显示出显著优于12个月的EFS率(22.86%对13.69%，p=0.008）与非ACEI/ARB组相比，而组间OS保持相似。在多变量分析中，使用ACEI/ARB与更好的12个月EFS相关(风险比=0.71,95%置信区间:0.52-0.96;p=0.024).性能差,晚期疾病状态，较高的CA19-9水平与较差的生存结局相关。
■在胰腺癌患者中同时使用ACEI/ARB可显著改善12个月EFS。年龄,性能状态，疾病状态,和较高的CA19-9水平是生存的独立预测因子。组合策略可能为PDAC患者提供更好的治疗结果。
■本研究旨在探讨肾素-血管紧张素系统(RAS)阻滞剂联合化疗对PDAC患者生存结局的影响。
■PDAC患者纳入回顾性研究。
■我们分析了2014年至2021年在我们机构接受PDAC（n=384）的患者。生存结果,包括无事件生存率（EFS）和总生存率（OS），根据RAS阻断剂的伴随使用情况进行分析。
■在研究的384名患者中，70（18.2％）同时接受了血管紧张素转换酶抑制剂（ACEI）和血管紧张素受体阻滞剂（ARB）。ACEI/ARB组患者，特点是年龄较大，合并症较多，显示出显著优于12个月的EFS率(22.86%对13.69%，p=0.008）与非ACEI/ARB组相比，而组间OS保持相似。在多变量分析中，使用ACEI/ARB与更好的12个月EFS相关(风险比=0.71,95%置信区间:0.52-0.96;p=0.024).性能差,晚期疾病状态，较高的CA19-9水平与较差的生存结局相关。
■在胰腺癌患者中同时使用ACEI/ARB可显著改善12个月EFS。年龄,性能状态，疾病状态,和较高的CA19-9水平是生存的独立预测因子。组合策略可能为PDAC患者提供更好的治疗结果。
