CAJ | 학술논문

目的：分析合并症对晚期老年肿瘤患者一线化疗疗效和预后的影响。方法对北京协和医院从2008-2012年收治的≥60岁晚期肿瘤患者进行回顾性研究。根据合并症情况分为无合并症、一般合并症和严重合并症3组；慢性疾病不影响重要脏器功能定义为一般合并症，重要脏器功能明显障碍定义为严重合并症。结果127例一线化疗的晚期肿瘤患者，中位年龄为67岁（60～85岁），完成了621个周期化疗，中位数为4个周期（1～9个周期）。无合并症（n=48例）、一般合并症（n=52例）、严重合并症（n=27例）3组的肿瘤控制率（包括部分缓解和疾病稳定者）分别为67%、64%和63%。一般合并症组与无合并症组相比，化疗剂量强度和毒副反应相当，无进展时间分别为9.31个月和8.56个月。严重合并症组平均化疗剂量强度为标准的（68.4±19.9）%，低于前两组（P=0.038）；无进展生存期为5.34个月，较前两组均明显缩短（P=0.02）。结论老年晚期肿瘤患者可以接受联合方案的一线化疗，合并症不影响患者的肿瘤控制率。有一般合并症的患者可以采用常规联合方案的化疗，严重合并症的患者是否联合方案化疗应慎重，化疗剂量应该进行适当调整，并且密切监测不良反应。
목적：분석합병증대만기노년종류환자일선화료료효화예후적영향。방법대북경협화의원종2008-2012년수치적≥60세만기종류환자진행회고성연구。근거합병증정황분위무합병증、일반합병증화엄중합병증3조；만성질병불영향중요장기공능정의위일반합병증，중요장기공능명현장애정의위엄중합병증。결과127례일선화료적만기종류환자，중위년령위67세（60～85세），완성료621개주기화료，중위수위4개주기（1～9개주기）。무합병증（n=48례）、일반합병증（n=52례）、엄중합병증（n=27례）3조적종류공제솔（포괄부분완해화질병은정자）분별위67%、64%화63%。일반합병증조여무합병증조상비，화료제량강도화독부반응상당，무진전시간분별위9.31개월화8.56개월。엄중합병증조평균화료제량강도위표준적（68.4±19.9）%，저우전량조（P=0.038）；무진전생존기위5.34개월，교전량조균명현축단（P=0.02）。결론노년만기종류환자가이접수연합방안적일선화료，합병증불영향환자적종류공제솔。유일반합병증적환자가이채용상규연합방안적화료，엄중합병증적환자시부연합방안화료응신중，화료제량응해진행괄당조정，병차밀절감측불량반응。
Objective To assess the role of comorbidity on treatment response and prognosis of elder cancer pa-tients treated with first line chemotherapy. Methods Cancer patients older than 60 years treated with chemotherapy from 2008 to 2012 in Peking Union Medical College Hospital were retrospectively reviewed. Results One hundred and twenty-seven elder cancer patients, with a mean age of 67 years old, were analyzed. They were divided into three groups:no comorbidity group (n=48), mild comorbidity group (n=52) and serious comorbidity group (n=27). The disease response rate (DRR) was 67%、64%and 63%in the three groups. There was no difference in the progress of free survival (PFS) be-tween no comorbidity group and mild comorbidity group (9.31 vs. 8.56 months). While the PFS was shorter in serious co-morbidity group (5.43 months, P=0.02). The relative dose intensity was lower in serious comorbidity group [(68.4 ±19.9)%, P = 0.038]. Conclusion Our results suggest that mild comorbidity does not influence the response rate of first line chemotherapy in elder patients. Treatment should be used under serious consideration in elder patients with severe comor-bidities.