Survival and prognostic tests in a real-world phase II experience with a safe, moderate-dose, sequential chemotherapy (CT) algorithm (ALGO) for metastatic pancreatic adenocarcinoma (PANC).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16763-e16763
Author(s):  
Robert L. De Jager ◽  
Howard Bruckner ◽  
Fred Bassali ◽  
Azriel Hirschfeld ◽  
Daniel Gurell ◽  
...  
Keyword(s):  
Prognostic Score ◽  
Severe Infection ◽  
Therapeutic Index ◽  
Individual Risk ◽  
Drug Synergism ◽  
Moderate Dose ◽  
Kaplan Meier ◽  
High Therapeutic Index ◽  
Prognostic Tests ◽  
Ecog Ps

e16763 Background: Gemcitabine (G), 5-fluorouracil (F), leucovorin (L), irinotecan (I), and oxaliplatin (O), (GFLIO) is safe, employs moderate 1/2-1/3 dosages, offers expanded eligibility (0-2 ECOG PS; no age limit)). Each step reverse resistance (RR) to CT; drug synergism 4-6 simultaneous pairs) improve responses (Rs) and survival (S) (Bruckner ASCO 05, 08, 11, AntiCancer Res 2016; 36 (1), 2018; 38 (1) (ACR), and the immune system (Correale P: J. Immunother 2014; 37). M Caraglia: Front Oncol. 2019). Methods: Eligibility: intent to treat active metastatic PANC, no prior CT: any age: PS 0-2 and expected > 6 weeks S. IRB required safety < 1/10 severe events. ALGO in mg/m2: G 500, F 12-1500 over 24 hrs, L 180, I 80, day2 O (GFLIO) q2 wks, and on progression added in sequence, day 2, docetaxel 20-25 and good counts only mitomycin C 3-6 then bevacizumab 10mg/kg with prior monitoring and modifications (ACR). Median 12, 18, 24 mos Overall Survival (OS), Kaplan Meier estimates with 95% CI were evaluated with age, sex and normal nl and abnl baseline bloods: neutrophils N ANC; Lymphs Ly ALC; platelets; albumin (ALB); Alkaline phosphatase (Alk Ph) abn N alb 3.5 N/L; 2.1 L/monocyte ratios and the A.L.A.N (AS) composite prognostic score (M. Salati E.J.Ca. 2019; 117: 84-90). Results: OS @ 6, 12, 18 & 24 mos, for 53 pts, was 75; 57; 36; 26 % (+/- 8-10%). Median M S was 14.5 mo (CI 9-17mos); S @ all ages ≥ 60, 65 or 70, was not inferior. Women's M S 17 mo. was > men's 10.5: 95/65; 75/46; 48/29; 42/29%. AS for abnl tests was: 0 (18pts): 93: 81: 48; 34% & MS 17 mo vs 1-2 (23)90: 58;42;32% & MS 15.5mo vs 3-4 (12)MS 3 mo. Pts with best 17-14.5 mo MS had nl AS 0 > Alb > AS 1-2 > APh > ANC. Pts with worst 3-6 mo MS had abnl: AS 3-4 < Alb < ANC. No pt had severe infection, neuropathy or gastroenteritis. Pts -/+ 75-100gm ascorbic acid, 25, did not have inferior S in ALAN subsets (H.Bruckner AACR 17). Conclusions: The sequential moderate dose CT ALGO improves eligbility and provides pts with metastatic PANC of any age a well tolerated CT regimen with a high therapeutic index and strong, 12, 18, 24 mo, survival. Prognostic tests can identify subgroups ≥ 75% with favorable vs. unfavorable criteria and improve personalized choices and measures to remedy individual risk factors. Clinical trial information: NCT01905150 .

Moderate dose serial therapy for aged and resistant patients with cholangiocarcinomas.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16160-e16160
Author(s):  
Howard Bruckner ◽  
Azriel Hirschfeld ◽  
Robert L. De Jager ◽  
Fred Bassali ◽  
Daniel Gurell ◽  
...  
Keyword(s):  
Real World ◽  
High Dose ◽  
Immune Functions ◽  
Moderate Dose ◽  
Adult Age ◽  
Prior Therapy ◽  
Kaplan Meier ◽  
Prognostic Tests ◽  
Intent To Treat ◽  
Clinical Trial Information

e16160 Background: Advanced (Adv) intrahepatic IH Cholangiocarcinoma BD trials found multi-drug, sequences (GFLIO) safely expand eligibility (El) for patients (pts) of all ages -/+ resistant Ca (R). Two series had response/survival (S) of 80% / > 2 years (yr) (Bruckner et al Anti Ca Res 16). Therapy reverses R to key drugs, improves the pts' many immune functions and exposure to neoantigens, (Caraglia RT et al Front Oncol 19.) A.L.A.N.(AS) blood tests (Ts) predict chances of S (Salati et al EuJCa 18). Methods: Kaplan-Meier analyses examine prognostic Ts as El criteria for real-world pts. El included poor risk pts: any adult age, +/- R (-/+ prior test drugs). El: Intent to treat; consent; adv measurable IHBD; active progression (pg); Performance 0-2 and expected 6 wks S. The inE have 2ary CNS, require IVs; are unable to reach office, or have gr3-4 toxicity. GFLIO every 2 wks in mg/M2: Gemcitabine 500; 5-Fluorouracil 1200 over 24 hrs; Leucovovorin 180 Irinotecan 80 and day (D)2, Oxaliplatin 40. On pg, drugs are added, none are discontinued: D2 docetaxel 20-25, -/+ Mitomycin C 4-6; on 2nd pg, D1 Cetuximab is added (KRAS wild), wkly, and replaced on 3rd pg with D1 bevacizumab 10 mg/kg every 2 wks. Baseline A.L.A.N. assays (AS) are in Salati ibid. Results: Survival of the 35 pts, 19 R, is: 84% at 1 yr and 64% (CI 50-78%) at 2 yrs, median S CI 22.5 - > 24 mos; S at 12, 18 and 24 mos: with no unfavorable (UF) AS0 Ts (12 pts), is 100, 100, and 90%; with 1-2 UF Ts (15pts), is 76, 66 and 66% (CI > 56%). With 3-4 UF Ts (8 pts) S is 67, 34, and 13%. The old, 14 > 70, and young S similarly (̃); 4/4 > 75 S in remission for > 2 yr. p. 0.36, HR 1.68. Pts, 19R/16 - prior therapy, S similarlỹ, p 0.96, HR 1.03; both groups have similar ̃ Ts AS. Females, 17, and males, in spite of a cluster with UF AS 3-4, have similar ̃ S, p 0.6, HR 1.4. GFLIO induction produced neither hospitalizations, neutropenic fevers nor severe neuropathy and no initial need for prophylactic or high dose granulocyte factors. Favorable (Fav) Ts include: low < 3.1 neutrophile-lymphocyte ratio, 57%of pts, 81% S 2yr, p 0.005 HR 9.4; 2-4/4 fav ALAN Ts, 77% of pts,78% S 2 yr, p 0.007, hr 6.3; low < 300,000 platelets 71%, 80% S 2 yr, p 0.01, HR 1.7, and high > 3.5 albumin,74% of pts,72% S 2yr, p 0.03, HR 3.9. Groups defined by single UF Ts (except low albumin, 33% S 2 yr) S > ̃ 50% at 2 yr. Conclusions: A real world, safe, survival of > 2yr, is confirmed in this 3rd series. This meets NCI criteria for: selective use, and development of GFLIO's elements (lowest effective dosages and sequential regimens), and prognostic tests (criteria and models). Therapy can, in theory, correct UF T's - pathology. When matched for AScore, GFLIO is ̃ effective, -/+, R and at all ages. Tests and GFLIO can change practice, improve El and survival for under treated pts, some half of all pts, the aged and the Resistant, told they have "only 6 or 12 mos to live." Clinical trial information: NCT01905150.

Nanoparticle-based Drug Delivery Systems for Targeted Epigenetics Cancer Therapy

2020 ◽  
Vol 21 (11) ◽  
pp. 1084-1098
Author(s):  
Fengqian Chen ◽  
Yunzhen Shi ◽  
Jinming Zhang ◽  
Qi Liu
Keyword(s):  
Drug Delivery ◽  
Side Effects ◽  
Cancer Therapy ◽  
Drug Delivery Systems ◽  
Therapeutic Index ◽  
Delivery Systems ◽  
Epigenetic Therapy ◽  
Cancer Therapies ◽  
Therapeutic Benefits ◽  
High Therapeutic Index

This review summarizes the epigenetic mechanisms of deoxyribonucleic acid (DNA) methylation, histone modifications in cancer and the epigenetic modifications in cancer therapy. Due to their undesired side effects, the use of epigenetic drugs as chemo-drugs in cancer therapies is limited. The drug delivery system opens a door for minimizing these side effects and achieving greater therapeutic benefits. The limitations of current epigenetic therapies in clinical cancer treatment and the advantages of using drug delivery systems for epigenetic agents are also discussed. Combining drug delivery systems with epigenetic therapy is a promising approach to reaching a high therapeutic index and minimizing the side effects.

Proline prodrug of melphalan, prophalan-l, demonstrates high therapeutic index in a murine melanoma model

2007 ◽  
Vol 67 (3) ◽  
pp. 752-758 ◽  
Author(s):  
Sachin Mittal ◽  
Yasuhiro Tsume ◽  
Christopher P. Landowski ◽  
Kyung-Dall Lee ◽  
John M. Hilfinger ◽  
...  
Keyword(s):  
Therapeutic Index ◽  
Murine Melanoma ◽  
Melanoma Model ◽  
High Therapeutic Index

Alliance A021501: Preoperative mFOLFIRINOX or mFOLFIRINOX plus hypofractionated radiation therapy (RT) for borderline resectable (BR) adenocarcinoma of the pancreas.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 377-377
Author(s):  
Matthew H. G. Katz ◽  
Qian Shi ◽  
Jeffrey P. Meyers ◽  
Joseph M. Herman ◽  
Michael Choung ◽  
...  
Keyword(s):  
Phase Ii ◽  
Interim Analysis ◽  
Historical Data ◽  
Ductal Adenocarcinoma ◽  
R0 Resection ◽  
Borderline Resectable ◽  
Novel Treatments ◽  
Kaplan Meier ◽  
Hypofractionated Radiation ◽  
Ecog Ps

377 Background: Neoadjuvant therapy has been associated with a median overall survival (OS) of 18 – 23 months (mo) in patients (pts) with BR pancreatic ductal adenocarcinoma (PDAC). To establish reference regimens to which novel treatments can be compared in future studies, we evaluated neoadjuvant mFOLFIRINOX with or without RT in BR PDAC in a phase II National Clinical Trials Network (NCTN) trial. Methods: Pts with ECOG PS 0-1 and BR PDAC confirmed by central real-time radiographic review after pre-registration were randomized to either arm A: 8 cycles of neoadjuvant mFOLFIRINOX (oxaliplatin 85 mg/m2, irinotecan 180 mg/m2, leucovorin 400 mg/m2 and infusional 5-fluorouracil 2400 mg/m2 over 46 hours), or arm B: 7 cycles of mFOLFIRINOX followed by stereotactic body RT (SBRT, 33-40 Gy in 5 fractions [fx]) or hypofractionated image guided RT (HIGRT, 25 Gy in 5 fx). Pts in either arm without disease progression underwent pancreatectomy, then 4 cycles of adjuvant mFOLFOX6 (oxaliplatin 85 mg/m2, leucovorin 400 mg/m2 and infusional 5-fluorouracil 2400 mg/m2 over 46 hours). The primary endpoint, 18-mo OS rate, of each arm was compared to a historical control of 50%. Planned interim analysis mandated closure of either arm in which <11 of first 30 accrued pts underwent R0 resection. Results: 155 pts pre-registered and 126 pts were enrolled to arm A (N=70; 54 randomized, 16 following closure of arm B) or arm B (N=56; closed at interim analysis, all pts randomized prior to closure). Median age (A: 63y, B: 67y), median CA 19-9 level (A: 171 U/ml, B: 248 U/ml) and ECOG PS (A: 51% PS 0, B: 57% PS 0) of registered pts were similar between arms (p > 0.05). Treatment detailed in Table. The 18-mo OS rate based on Kaplan Meier estimates was 67.9% (95%CI: 54.6 – 78.0) in arm A and 47.3% (95%CI: 33.7 – 59.7) in arm B. Among pts who underwent pancreatectomy, 18-mo OS rate was 93.1% (95%CI: 84.3 – 100) and 78.9% (95%CI: 62.6 – 99.6) in arm A and B, respectively. With median follow-up of 27 and 31 mo, median OS was 31.0 (95%CI: 22.2 – NE) mo and 17.1 (95%CI: 12.8 – 24.4) mo in arm A and B, respectively. Conclusions: Neoadjuvant mFOLFIRINOX was associated with favorable OS relative to historical data in pts with BL PDAC in this phase II NCTN trial. mFOLFIRINOX with hypofractionated RT did not improve OS compared to historical data. mFOLFIRINOX represents a reference regimen in this setting and a backbone on which to add novel agents. Support: U10CA180821, U10CA180882, U24CA196171; https://acknowledgments.alliancefound.org Clinical trial information: NCT02839343. [Table: see text]

Balanoposthitis: issues of classification, diagnosis and approaches to therapy

2021 ◽  
pp. 39-44
Author(s):  
A. V. Ignatovsky
Keyword(s):  
Therapeutic Index ◽  
Therapy Options ◽  
Human Papillomavirus Infection ◽  
Papillomavirus Infection ◽  
Choice Of Treatment ◽  
High Therapeutic Index ◽  
Modern Classification ◽  
Aerobic And Anaerobic

Objective. To present a variant of the modern classification of the processes occurring with lesions of the genitals, to draw specialists’ attention to the peculiarities and variety of causes leading to inflammation of the glans and foreskin, as well as to discuss topical issues of external therapy of balanopostitis.Material and methods. Data from modern studies and clinical guidelines were used in the preparation of the publication.Results. The variety of variants of lesions of the glans and foreskin can be due to a number of reasons and can be either an independent local process or a fragment of dermatosis, where it is possible to be affected in the form of balanoposthitis. Also, when examining and selecting therapy options, it is important to consider the possible role of microorganisms, whose spectrum as a cause of balanoposthitis varies from aerobic and anaerobic, to viral and fungal microflora. Treatment approaches are determined by the etiological factors.Conclusions. Balanoposthitis is a heterogeneous group of nosologies. The choice of treatment is based on the identified cause or empirically when possible. External therapy and hygiene constitute an essential part of treatment. When choosing drugs for topical glucocorticosteroids, preferenceshould be given to drugs with a high therapeutic index and low atrophogenic potential. Dysplastic processes of the penis are associated with human papillomavirus infection, the treatment of which can be both conservative and destructive.

scholarly journals The Glasgow Prognostic Score Determined During Concurrent Chemoradiotherapy Is an Independent Predictor of Survival for Cervical Cancer

2015 ◽  
Vol 25 (7) ◽  
pp. 1306-1314 ◽  
Author(s):  
Takeshi Nishida ◽  
Keiichiro Nakamura ◽  
Junko Haraga ◽  
Chikako Ogawa ◽  
Tomoyuki Kusumoto ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Concurrent Chemoradiotherapy ◽  
Multivariate Analyses ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Disease Free Survival ◽  
Kaplan Meier ◽  
The Glasgow Prognostic Score ◽  
Prediction Of Prognosis

ObjectiveThe Glasgow prognostic score (GPS) determined at pretreatment is important in the prediction of prognosis in various cancers. We investigated if the GPS used both at pretreatment and during concurrent chemoradiotherapy (CCRT) could predict the prognosis of patients with cervical cancer.MethodsWe collected GPS and clinicopathological data from the medical records of 91 patients who underwent CCRT for cervical cancer; their GPSs at pretreatment and during CCRT were retrospectively analyzed for correlations with recurrence and survival. Statistical analyses were performed using the Mann-WhitneyUtest. Disease-free survival (DFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Cox’s proportional hazard regression was used for univariate and multivariate analyses.ResultsThe median follow-up for all patients who were alive at the time of last follow-up was 38.0 months (range, 1–108 months). The DFS and OS rates of patients with a high GPS during CCRT (GPS 1 + 2; 55 patients; 60.4%) were significantly shorter than those for patients with a low GPS (GPS 0; 36 patients; 39.6%) (DFS,P< 0.001; OS,P< 0.001). Furthermore, multivariate analyses showed that high GPS during CCRT was an independent prognostic factor of survival for OS (P= 0.008).ConclusionsDuring CCRT, a high GPS was revealed to be an important predictor of survival for cervical cancer.

scholarly journals Anti-anxiety activity of Eucalyptus tereticornis n-hexane extract in Wistar albino rats

2017 ◽  
Vol 6 (3) ◽  
pp. 577
Author(s):  
Shyamjith Manikkoth ◽  
Sheeba Damodar ◽  
Melinda Sequeira ◽  
Kevin Samuel
Keyword(s):  
Therapeutic Index ◽  
Antioxidant Property ◽  
Hexane Extract ◽  
Albino Rats ◽  
Group Iii ◽  
Group I ◽  
Plus Maze ◽  
High Therapeutic Index ◽  
Group Ii ◽  
Wistar Albino Rats

Background: To find out a new agent with a high therapeutic index for the treatment of anxiety, an indigenous medicinal plant Eucalyptus terteticornis was screened for its effect on anxiety in experimental animal model.Methods: Thirty six adult Wistar albino rats of both sexes weighing 175-200g were divided into three groups: Group I: DMSO 10% (0.1ml/200g), Group II: hexane extract of leaves of Eucalyptus terteticornis (ETHE) (100mg/kg/body weight), Group III: Diazepam (1mg/kg orally). All test compounds were administered orally for ten days. On tenth day, after one hour of test compounds administration, Wistar rats were taken for elevated plus maze (EPM) and light dark arena (LDA) tests. Statistical comparisons among the groups were performed by One-way analysis of variance (ANOVA) followed by Tukey Krammer test.Results: The results showed that ETHE treated animals (Group II) significantly (p <0.001) increased the time spent in open arms of EPM and in bright arena of LDA on comparing with normal (Group I).Conclusions: The anti-anxiety activity of Eucalyptus terteticornis can be due to its effect on brain neurotransmitters or due to antioxidant property.

Prognostic role of inflammatory biomarkers from peripheral blood and clinical factors in metastatic castration-resistant prostate cancer (mCRPC) patients (pts) treated with radium-223 (Ra-223) (BIO-Ra-223 study).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17026-e17026
Author(s):  
Sara Elena Rebuzzi ◽  
Matteo Bauckneht ◽  
Alessio Signori ◽  
Viviana Frantellizzi ◽  
Elisa Lodi Rizzini ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Peripheral Blood ◽  
Scoring System ◽  
Prognostic Score ◽  
Clinical Factors ◽  
Prognostic Role ◽  
Internal Validation ◽  
Prognostic Groups ◽  
Ecog Ps

e17026 Background: Ra-223 is a treatment option for mCRPC pts with bone metastases according to the survival benefit observed compared to placebo in the ALSYMPCA trial. In the last years, many studies showed this benefit in the real-life pts is lower than that reported in the trial, probably due to a suboptimal selection of pts with poor prognostic characteristics. Therefore, the identification of prognostic factors to select mCRPC pts most likely to benefit from Ra-223 is needed. The multicentre retrospective BIO-Ra-223 study has investigated the prognostic role of peripheral blood immune cells and clinical factors to develop a novel prognostic score for mCRPC pts treated with Ra-223. Methods: Complete blood count was assessed before Ra-223 treatment calculating neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII). Clinical factors included pre-treatment Eastern Cooperative Oncology Group performance status (ECOG PS), Gleason Score (GS) group, number of bone metastases, alkaline phosphatase (ALP), line of therapy, previous chemotherapy and the presence of lymphadenopathies. Statistical analyses included survival ROC curves for biomarkers’ cutoffs, univariable and multivariable Cox analyses, internal validation, c-index calculation and Schneeweiss scoring system. Results: From September 2013 to July 2020, 519 mCRPC pts received Ra-223 as 1st-2nd, 3rd-4th and further-line in 48%, 38% and 14% of pts. The median overall survival (mOS) of the entire cohort was 19.9 months. All biomarkers and clinical factors (except for GS group) significantly predicted OS at the univariable analyses. In the multivariable ones, all biomarkers, ECOG PS, number of bone metastases and ALP significantly correlated with OS. The multivariable model with NLR (< 3.1 vs ≥3.1), ECOG PS (0-1 vs 2-3), number of bone metastases (< 6, 6-20, > 20) and ALP (< 220 vs ≥220) showed the highest c-index (0.711), which was maintained after internal validation (bootstrap re-sampling) (c-index: 0.707). Using the Schneeweiss scoring system, ten categories were identified in 494 pts with complete data and merged in two prognostic groups with distinctive OSs: group 1 (score 0-4, 337 pts) with a mOS of 27.8 months and group 2 (score 5-10, 157 pts) with a mOS of 9.7 months (HR 4.03, p < 0.001). Conclusions: The obtained score, composed of NLR, ECOG PS, number of bone metastases, and ALP identifies two distinctive prognostic groups of mCRPC pts. Moreover, this score is easily and widely applicable for clinical practice and trials at no additional costs. Although external validation is needed, these preliminary results showed that this novel prognostic score is promising and could help the patients’ selection for Ra-223 treatment.

Do Benzodiazepines Still Deserve a Major Role in The Treatment of Psychiatric Disorders? A Critical Reappraisal

2013 ◽  
Vol 28 (1) ◽  
pp. 7-20 ◽  
Author(s):  
B. Dell’osso ◽  
M. Lader
Keyword(s):  
Psychiatric Disorders ◽  
Critical Appraisal ◽  
Randomized Clinical Trials ◽  
Treatment Guidelines ◽  
Scientific Evidence ◽  
Family Physicians ◽  
Therapeutic Index ◽  
The Elderly ◽  
High Therapeutic Index

AbstractDiscovered in the late 1950s by Leo Sternbach, the first benzodiazepine (BZD) chlordiazepoxide was followed by several congeners, which rapidly constituted one of the largest and most widely prescribed classes of psychotropic compounds. After 50 years, BZDs are still routinely utilized not only in psychiatry but, more generally, in the whole of medicine. Despite their high therapeutic index which makes BZDs safer than other compounds like barbiturates, as well as their rapidity of onset, psychiatrists and family physicians are well aware about the controversy that surrounds the wide use – often not adequately based on scientific evidence – of BZDs in many psychiatric disorders. In this overview of international treatment guidelines, systematic reviews and randomized clinical trials, the aim was to provide a critical appraisal of the current use and role of BZDs in psychiatric disorders and their disadvantages, with specific emphasis on anxiety and affective disorders, sleep disorders, alcohol withdrawal, violent and aggressive behaviours in psychoses, and neuroleptic-induced disorders. In addition, specific emphasis has been given to the extent of usage of BZDs and its appropriateness through the assessment of available international surveys. Finally, the entire spectrum of BZD-related adverse effects including psychomotor effects, use in the elderly, paradoxical reactions, tolerance and rebound, teratologic risk, dependence, withdrawal and abuse issues was examined in detail.

scholarly journals Modified Glasgow prognostic score can predict survival of muscle invasive bladder cancer patients after radiotherapy

2020 ◽  
Vol 61 (4) ◽  
pp. 616-621
Author(s):  
Koyo Kikuchi ◽  
Ryuji Nakamura ◽  
Takafumi Segawa ◽  
Hirobumi Oikawa ◽  
Hisanori Ariga
Keyword(s):  
Bladder Cancer ◽  
Cancer Patients ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Cox Regression Analysis ◽  
Modified Glasgow Prognostic Score ◽  
Kaplan Meier ◽  
Muscle Invasive

Abstract In patients with various cancers, modified Glasgow prognostic score (mGPS) before treatment has predicted prognoses after antitumor therapy. This study aimed to assess whether pretreatment mGPS also has predictive value in patients with muscle-invasive bladder cancer (MIBC) after radiotherapy. A retrospective review accumulated 98 consecutive MIBC patients treated with definitive 3D-conformal radiotherapy from January 2011 to December 2016 in a single center. It included cT2-4bN0-3M0 patients with a median age of 79 years (range: 49 to 95 years). Radiotherapy was delivered at 60–66 Gy for bladder cancer. Patients were categorized in terms of their pretreatment serum albumin and C-reactive protein (CRP) values as mGPS_0, mGPS_1, and mGPS_2. Among them, cumulative overall survival (OS) rates were compared by Kaplan–Meier plots with log-rank tests. The number of patients with mGPS_0, mGPS_1, and mGPS_2 were 40, 40, and 18, respectively. The median follow-up time for all patients was 19 months (range: 2–73 months). The 2-year OS rate for all patients was 75.7%. The 2-year OS rates for mGPS_0, mGPS_1, and mGPS_2 were 85.1%, 71.3%, and 60.9%, respectively. Kaplan–Meier curves revealed a significantly higher cumulative OS rate for mGPS_0 compared with mGPS_1 and mGPS_2 (P = 0.003). Using multivariate Cox regression analysis, mGPS_0 and good performance status were associated with favorable OS rates, of which mGPS_0 was more significant (Hazard ratio 2.74, 95% CI 1.30–5.57, P = 0.008). Modified Glasgow prognostic score may be a novel biomarker that can predict survival in patients with MIBC after radiotherapy.

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