RESUMO
Background: Primary brain tumors are relatively rare malignancy, with high-grade gliomas (glioblastoma multiforme and anaplastic gliomas) are the most common types. We aimed to evaluate the prognostic value of Prognostic Nutritional Index (PNI), which is calculated by lymphocyte count and albumin, in recurrent glioblastoma patients treated with systemic treatment. Methods: Data of 64 patients with recurrent glioblastoma who received systemic treatment and followed in our clinic between 2012 and 2018 was retrospectively collected and analyzed. PNI was calculated as: [(10×serum albumin (g/dL))+(0.005×total lymphocyte count)]. Patients were categorized according to the median PNI value. We investigated the prognostic role of PNI groups, and survival outcomes. Results: Median value of PNI was 45.7, and median follow-up duration was 9 months (168 months). Median overall survival (OS) was 7.9 months (95%CI: 5.510.4). Median OS was significantly longer in patients with PNI>45.7 compared to patients with PNI≤45.7 (13.9 months (95%CI: 10.517.4), and 4.6 months (95%CI: 2.56.8), p<0.001, respectively). In multivariate analysis, PNI was found to be an independent prognostic factor for OS [HR:0.41 (95%CI:0.220.74), p=0.03)]. Conclusion: In our study, the PNI was found to be an independent prognostic biomarker in patients with recurrent glioblastoma, but further prospective trials are necessary to validate its prognostic role (AU)
Antecedentes: Los tumores cerebrales primarios son neoplasias malignas relativamente infrecuentes, siendo los gliomas de alto grado (glioblastomas multiformes y gliomas anaplásicos) los tipos más comunes. Nuestro objetivo fue evaluar el valor pronóstico de Prognostic Nutritional Index (PNI), que se calcula mediante el recuento de linfocitos y albúmina en los pacientes con glioblastoma recurrente tratados con terapia sistémica. Métodos: Se recabaron y analizaron retrospectivamente los datos de 64 pacientes con glioblastoma recurrente que recibieron tratamiento sistémico, y a quienes se realizó seguimiento en nuestra clínica entre 2012 y 2018. Se calculó PNI como: (10×albúmina sérica [g/dl]+0,005×recuento linfocitario total). Se categorizó a los pacientes con arreglo al valor medio de PNI. Estudiamos el papel pronóstico de los grupos PNI, y los resultados de supervivencia. Resultados: El valor medio de PNI fue de 45,7, siendo la duración media del seguimiento de 9 meses (1-68 meses). La supervivencia global (SG) fue de 7,9 meses (IC 95%: 5,5-10,4). La SG media fue significativamente más alta en los pacientes con PNI>45,7 en comparación con los pacientes con PNI≤45,7 (13,9 meses, IC 95%: 10,5-17,4 y 4,6 meses, IC 95%: 2,5-6,8; p<0,001, respectivamente). En el análisis multivariante, se encontró que PNI era un factor pronóstico independiente de la SG (HR: 0,41; IC 95%: 0,22-0,74; p=0,03). Conclusión: En nuestro estudio, encontramos que PNI era un biomarcador pronóstico independiente en los pacientes con glioblastoma recurrente, aunque son necesarios más estudios prospectivos para validar su papel pronóstico (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Glioblastoma/terapia , Avaliação Nutricional , Recidiva Local de Neoplasia , Estudos Retrospectivos , Glioblastoma/mortalidade , PrognósticoRESUMO
PURPOSE: Enzalutamide and abiraterone acetate (AA) are the main therapeutic approaches for the treatment of metastatic castration-resistant prostate cancer (mCRPC) after the failure of androgen deprivation therapy during or following docetaxel-based chemotherapy. The aim of the present study was to investigate the role of early prostate-specific antigen (PSA) decline (four weeks after anti-androgen therapy) in predicting long-term progression-free survival (PFS). METHODS: In this retrospective study, we evaluated 65 patients who had histologically confirmed metastatic prostate cancer and were treated with AA or enzalutamide in the post-docetaxel period. Serum PSA levels were evaluated at 4th and then 12th week. The main goal of this study was to demonstrate that an early PSA decline predicts PFS. RESULTS: Between May 2015 and June 2019, the medical records of 65 patients were collected. Of these patients, 38 (58.5%) received AA and 27 (41.5%) enzalutamide. Early PSA response rate (RR; ≥ 30% and ≥ 50% from baseline at the 4th week) was identified in 38.5% (n=25) and 15.3% (n=10) of the patients, respectively. In multivariate analysis, we found that PSA RR≥ 30% in patients had a statistically significant advantage in terms of PFS ( HR: 0.38, 95% CI (0.13-0.71;p=0.03). CONCLUSION: In conclusion, 30% PSA RR was significantly associated with a better PFS.