临床肿瘤学杂志
臨床腫瘤學雜誌
림상종류학잡지
CHINESE CLINICAL ONCOLOGY
2014年
3期
244-248
,共5页
进展期胃癌%老年%生存%预后
進展期胃癌%老年%生存%預後
진전기위암%노년%생존%예후
Advanced gastric cancer%Elderly%Survival%Prognosis
目的:探讨老年进展期胃癌患者的预后及影响预后的因素。方法回顾性分析2010年1月至2012年12月174例≥70岁接受化疗的进展期胃癌患者的临床资料,生存分析采用Kaplan-Meier法,多因素分析采用Cox比例风险模型。结果174例患者一线化疗的有效率(RR)为31?5%(51/162),疾病控制率(DCR)为73?5%(119/162),中位生存期(OS)为11?4个月(95% CI:10?4~12?4月),1年、2年生存率为39?0%和17?0%。两药方案的RR和中位OS高于单药方案(35?8% vs.17?9%,P=0?037;14?1个月和7?5个月,P=0?010),两方案DCR的差异无统计学意义;化疗1~2个周期、3~4个周期、≥5个周期的中位OS分别为7?7个月、13?1个月和21?5个月( P<0?001);仅接受一线化疗132例患者的中位OS为10?7个月,接受二线化疗42例患者的中位OS为16?7个月( P=0?006)。 Cox多因素分析显示,ECOG评分、转移个数、癌胚抗原、糖类抗原199、乳酸脱氢酶、化疗周期数和进展后是否接受二线化疗是影响预后的独立因素。结论多周期化疗和一线化疗进展后接受二线化疗可改善老年进展期胃癌患者的预后。
目的:探討老年進展期胃癌患者的預後及影響預後的因素。方法迴顧性分析2010年1月至2012年12月174例≥70歲接受化療的進展期胃癌患者的臨床資料,生存分析採用Kaplan-Meier法,多因素分析採用Cox比例風險模型。結果174例患者一線化療的有效率(RR)為31?5%(51/162),疾病控製率(DCR)為73?5%(119/162),中位生存期(OS)為11?4箇月(95% CI:10?4~12?4月),1年、2年生存率為39?0%和17?0%。兩藥方案的RR和中位OS高于單藥方案(35?8% vs.17?9%,P=0?037;14?1箇月和7?5箇月,P=0?010),兩方案DCR的差異無統計學意義;化療1~2箇週期、3~4箇週期、≥5箇週期的中位OS分彆為7?7箇月、13?1箇月和21?5箇月( P<0?001);僅接受一線化療132例患者的中位OS為10?7箇月,接受二線化療42例患者的中位OS為16?7箇月( P=0?006)。 Cox多因素分析顯示,ECOG評分、轉移箇數、癌胚抗原、糖類抗原199、乳痠脫氫酶、化療週期數和進展後是否接受二線化療是影響預後的獨立因素。結論多週期化療和一線化療進展後接受二線化療可改善老年進展期胃癌患者的預後。
목적:탐토노년진전기위암환자적예후급영향예후적인소。방법회고성분석2010년1월지2012년12월174례≥70세접수화료적진전기위암환자적림상자료,생존분석채용Kaplan-Meier법,다인소분석채용Cox비례풍험모형。결과174례환자일선화료적유효솔(RR)위31?5%(51/162),질병공제솔(DCR)위73?5%(119/162),중위생존기(OS)위11?4개월(95% CI:10?4~12?4월),1년、2년생존솔위39?0%화17?0%。량약방안적RR화중위OS고우단약방안(35?8% vs.17?9%,P=0?037;14?1개월화7?5개월,P=0?010),량방안DCR적차이무통계학의의;화료1~2개주기、3~4개주기、≥5개주기적중위OS분별위7?7개월、13?1개월화21?5개월( P<0?001);부접수일선화료132례환자적중위OS위10?7개월,접수이선화료42례환자적중위OS위16?7개월( P=0?006)。 Cox다인소분석현시,ECOG평분、전이개수、암배항원、당류항원199、유산탈경매、화료주기수화진전후시부접수이선화료시영향예후적독립인소。결론다주기화료화일선화료진전후접수이선화료가개선노년진전기위암환자적예후。
Objective To investigate the prognosis and related influencing factors for elderly advanced gastric cancer. Methods The data of 174 patients over 70 years with advanced gastric cancer who received chemotherapy from January 2010 and December 2012 was reviewed. Kaplan-Meier method was employed to analyze survival and Cox proportional hazard model was used for multifactor analysis.Results The response rate (RR) was 31?? 5%(51/162)and the disease control rate (DCR) was 73?? 5%(119/162).The median overallsurvival (OS) was 11?? 4 months (95% CI: 10?? 4-12?? 4) and the 1-, 2-year survival rates were 39?? 0% and 17?? 0%. The RR and medianOS of 2-drug therapy were better than those of monotherapy (35?? 8% vs. 17?? 9%, P=0?? 037; 14?? 1months vs. 7?? 5 months,P=0?? 010), butthe difference of DCR had no significance (P>0?? 05). The median OS of patients receiving chemotherapy of 1-2, 3-4 and >5 cycles were7?? 7, 13?? 1 and 21?? 5months (P<0?? 001). The median OS of receiving first-line therapy alone was shorter than those receiving second-lineafter disease progression (10?? 7 months vs. 16?? 7 months, P=0?? 006). Cox regression model showed that ECOG score, number of metastat-ic lesions, CEA, CA19-9, lactate dehydrogenase, chemotherapy cycles and the second-line chemotherapy were the independentprognostic factors influencing prognosis. Conclusion Multiple cycles of chemotherapy and the application of second-line chemotherapyafter disease progression may improve the prognosis of elderly patients bearing advanced gastric cancer.