CAJ | 학술논문

目的：探讨一线应用表柔比星、奥沙利铂联合卡陪他滨方案(EOX方案)的晚期胃癌患者其肿瘤相关性贫血与预后的关系。方法选取2012-2013年本院应用EOX方案的晚期胃癌患者58例，根据治疗前以及治疗过程中血红蛋白水平分为贫血组(A1，Hb＜120 g/L)和非贫血组(A0，Hb＞120 g/L)，分析两组预后的差异。结果贫血组无疾病进展期(progress free survival，PFS)、总生存期(overall survival，OS)均略短于非贫血组，差异有统计学意义(5.3个月vs 7.2个月，P=0.032；13.6个月vs 17.1个月，P=0.027)，COX多因素回归分析显示，非贫血组较贫血组进展风险降低25%(HR=0.75，95%CI：0.413~0.914，P=0.018)；死亡风险降低26%(HR=0.74，95%CI：0.452~0.921，P=0.032)。结论出现肿瘤相关性贫血的胃癌患者无进展生存时间和总生存时间均略短于非贫血组患者，贫血是胃癌预后不良的独立影响因素之一，纠正贫血有望改善预后。
목적：탐토일선응용표유비성、오사리박연합잡배타빈방안(EOX방안)적만기위암환자기종류상관성빈혈여예후적관계。방법선취2012-2013년본원응용EOX방안적만기위암환자58례，근거치료전이급치료과정중혈홍단백수평분위빈혈조(A1，Hb＜120 g/L)화비빈혈조(A0，Hb＞120 g/L)，분석량조예후적차이。결과빈혈조무질병진전기(progress free survival，PFS)、총생존기(overall survival，OS)균략단우비빈혈조，차이유통계학의의(5.3개월vs 7.2개월，P=0.032；13.6개월vs 17.1개월，P=0.027)，COX다인소회귀분석현시，비빈혈조교빈혈조진전풍험강저25%(HR=0.75，95%CI：0.413~0.914，P=0.018)；사망풍험강저26%(HR=0.74，95%CI：0.452~0.921，P=0.032)。결론출현종류상관성빈혈적위암환자무진전생존시간화총생존시간균략단우비빈혈조환자，빈혈시위암예후불량적독립영향인소지일，규정빈혈유망개선예후。
Objective To assess the relationship between cancer related anemia (CRA) and prognosis in patients with advanced gastric cancer who were treated by Epirubicin Oxaliplatin and Xeloda as first-line chemotherapy.Methods Clinical data about 58 patients diagnosed with advanced gastric cancer who underwent first-line chemotherapy of EOX regimen at least 2 cycles in our hospital from 2012 to 2013 were retrospectively analyzed. According to the level of hemoglobin before and during treatment period, the patients were divided into two groups: anemia group (A1) and the absent group (A0).The relationship between CRA and clinical outcome of these two groups were analyzed.ResultsThe median PFS and OS in group A1 were significantly lower than group A0 (5.3 vs 7.2 m,P=0.032; 13.6vs17.1 m,P=0.027). The multivariate Cox analysis showed that the adjusted hazard ratio (HR) of PFS in anemia group was 25% lower than group A0 (HR 0.75, 95% CI: 0.413-0.914, P=0.018). The mortality risk of OS was 26% lower than group A0 (HR 0.74, 95%CI: 0.452-0.921, P=0.032).Conclusion The anemia patients are likely to have a shorter PFS and OS compared with normal patients. The cancer related anemia is an independent prognostic factor. Prospective trials are required to validate those findings.