CAJ | 학술논문

目的通过对老年患者查尔森指数(WIC)的分级和年龄的分层,评估老年食管癌患者对放化综合治疗的耐受性. 方法回顾性分析596例老年食管癌患者进行放化疗的完成情况,根据是否配合全身化疗分为放化疗组和放疗组,并将患者分为70～、75～、80～和≥85岁四个年龄层,结合查尔森指数和各自的完成情况评估对治疗的耐受性. 结果共有185例完成放化疗,113例进行了减量放化疗,81例中止放化疗,160例完成单纯根治性放射治疗,57例未完成放疗.进一步分析发现:减量组年龄≥75岁与＜75岁之间差异有统计学意义(x2=6.815,P=0.009),WIC≥1和＜1之间差异有统计学意义(x2=10.636,P=0.001);中止放化疗组年龄≥80岁与＜80岁之间差异有统计学意义(x2=63.842,P=0.000),WIC=0、1和≥2间的差异也有统计学意义(x2=21.153,P=0.000). 结论对老年食管癌患者治疗前进行WIC评分和年龄分层是必要的,对于≥75岁和WIC≥1的患者降低剂量的治疗更能获益,对于≥80岁和WIC＞1的患者进行放化疗时需要更为谨慎.
목적 통과대노년환자사이삼지수(WIC)적분급화년령적분층,평고노년식관암환자대방화종합치료적내수성. 방법 회고성분석596례노년식관암환자진행방화료적완성정황,근거시부배합전신화료분위방화료조화방료조,병장환자분위70～、75～、80～화≥85세사개년령층,결합사이삼지수화각자적완성정황평고대치료적내수성. 결과 공유185례완성방화료,113례진행료감량방화료,81례중지방화료,160례완성단순근치성방사치료,57례미완성방료.진일보분석발현:감량조년령≥75세여＜75세지간차이유통계학의의(x2=6.815,P=0.009),WIC≥1화＜1지간차이유통계학의의(x2=10.636,P=0.001);중지방화료조년령≥80세여＜80세지간차이유통계학의의(x2=63.842,P=0.000),WIC=0、1화≥2간적차이야유통계학의의(x2=21.153,P=0.000). 결론 대노년식관암환자치료전진행WIC평분화년령분층시필요적,대우≥75세화WIC≥1적환자강저제량적치료경능획익,대우≥80세화WIC＞1적환자진행방화료시수요경위근신.
Objective To assess the tolerance of elderly patients with esophageal carcinoma to chemoradiotherapy through.Methods A retrospective analysis of 596 elderly patients with esophageal carcinoma receiving chemoradiotherapy was conducted.Patients were divided into radiachemotherapy group and radiotherapy group,and according to age,patients were divided into four age groups (aged 70-74,75-79,80 80 and 85years and over).The tolerance to treatment was assessed by Charlson index.Results 185 patients completed chemoradiotherapy,113 patients reduced the dose of chemotherapy (reduction group),81 patients unfinished chemoradiotherapy (unfinished CRT group),160 patients completed radical radiotherapy alone (unfinished RT group),and 57 patients incompleted radiotherapy.Further analysis found that the tolerance to treatment in reduction group had significant differences between patients aged ≥ 75 years and ＜ 75 years (x2 =6.815,P=0.009),and between WIC ≥ 1 and ＜ 1(x2 =10.636,P=0.001); the tolerance to treatment in unfinished CRT group had significantly differences between aged ≥ 80 years and ＜80 years (x2 =63.842,P=0.000),and between WIC =0,1 and ≥ 2 (x2 =21.153,P=0.000).Conclusions Further age re-grouping and WIC assessment is necessary before treating esophageal cancer patients.Reduction of therapy dosage is more beneficial for patients aged ≥ 75 years and WIC≥1,and greater caution is required in chemotherapy for patients aged ≥ 80 years and WIC＞1.