1. Chemotherapy-induced neutropenia as a prognostic factor in patients with metastatic pancreatic cancer treated with gemcitabine.
- Author
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Otake, Aki, Tsuji, Daiki, Taku, Keisei, Kawasaki, Yohei, Yokoi, Mari, Nakamori, Harumi, Osada, Marika, Matsumoto, Megumi, Inoue, Kazuyuki, Hirai, Keita, and Itoh, Kunihiko
- Subjects
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THERAPEUTIC use of antimetabolites , *ANTIMETABOLITES , *C-reactive protein , *CONFIDENCE intervals , *METASTASIS , *MULTIVARIATE analysis , *NEUTROPENIA , *PANCREATIC tumors , *PROBABILITY theory , *RESEARCH , *STATISTICS , *SURVIVAL analysis (Biometry) , *MATHEMATICAL variables , *PROPORTIONAL hazards models , *RETROSPECTIVE studies , *LOG-rank test , *PROGNOSIS - Abstract
Purpose: Chemotherapy-induced neutropenia (CIN) is a common side effect of chemotherapy and an important dose-limiting factor. However, an association between CIN development and longer survival was recently reported in several solid cancers. In the present study, we aimed to assess whether CIN could be a prognostic factor and clarify other prognostic factors for patients with metastatic pancreatic cancer. Methods: We retrospectively analyzed the medical records of 84 patients who received gemcitabine monotherapy as first-line chemotherapy for metastatic pancreatic cancer to assess whether CIN could be a prognostic factor. Potential prognostic factors of survival were examined by univariate and multivariate analyses using the log-rank test and Cox proportional hazard model, respectively. Results: Median survival time was 170 days [95% confidence interval (CI), 147-193] in patients without CIN (grade 0), 301 days (95% CI, 152-450) in patients with grade 1-2 CIN, and 406 days (95% CI, 271-541) in patients with grade 3 CIN. The multivariate analysis revealed that a pretreatment C-reactive protein level of <0.50 mg/dL [hazard ratio (HR), 0.534; 95% CI, 0.323-0.758, P = 0.015] and grade 3 CIN (HR, 0.447; 95% CI, 0.228-0.875, P = 0.019) were independent favorable prognostic factors in patients with metastatic pancreatic cancer treated with gemcitabine. Conclusions: Neutropenia during chemotherapy was associated with increased survival of patients with metastatic pancreatic cancer. Monitoring of CIN could be used to predict treatment responsiveness. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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