老年复发卵巢癌患者预后影响因素的临床分析  

Clinical ananlysis of prognostic factors for elderly patients with recurrent ovarian cancer

作　　者：朱滔[1] 倪镌[1] 楼寒梅[1] 

机构地区：[1]浙江省肿瘤医院妇瘤科,浙江杭州310022

出　　处：《中国癌症杂志》2011年第2期130-133,共4页China Oncology

摘　　要：背景与目的:老年卵巢癌患者预后差,生存率明显低于年轻患者,本研究旨在探讨老年复发卵巢癌的临床病理特点对预后的影响。方法:回顾性分析1999年3月—2009年12月在我院治疗的铂类敏感型复发卵巢癌患者共235例,其中老年组52例(年龄≥65岁),非老年组183例(年龄<65岁),采用单因素及多因素分析对年龄、二线化疗方案、PS评分和二次减瘤术后残瘤等预后影响因素进行分析。结果:老年组进行二次减瘤术的患者较非老年组明显下降(8.7%比24.6%,P=0.001 8)。行二次减瘤术患者的中位生存时间为35.6个月,而未行二次减瘤术者为20.7个月,差异有统计学意义(P=0.02)。二线化疗中,老年组接受单药铂类化疗较非老年组多(45.3%比22.1%,P=0.006)。二线化疗为单药铂类化疗的中位生存时间为21.6个月,而联合铂类化疗的为32.8个月,差异有统计学意义(P=0.006)。中位生存期老年组为23.7个月,非老年组为31.2个月(P=0.165)。多因素分析结果显示,复发年龄、分期、二线化疗方案、复发时PS评分、初次化疗后肿瘤无进展生存期、复发病灶数、手术后残瘤等因素与生存期独立相关(P<0.05)。结论:复发年龄、分期和二线化疗为铂类联合化疗、PS评分、初次化疗后肿瘤无进展生存期、复发病灶数、二次减瘤术后残瘤是复发卵巢癌预后的独立影响因素,正确地选择二次减瘤术加铂类联合化疗作为老年复发卵巢癌的二线治疗将提高疗效。Background and purpose：Due to poor prognosis of ovarian cancer in elderly patients,lower survival rates than in younger patients,this study investigated the effects of pathological and clinical characteristics and the methods of treatment for the prognosis of elderly patients with platinum-sensitive recurrent ovarian cancer.Methods：A retrospective analysis of patients with recurrent platinum-sensitive ovarian cancer consecutively treated between March 1999 and December 2009 in the Zhejiang Cancer Hospital.A total of 235 patient files were collected and analyzed.Among them,52 patients ≥65 years of age（the elderly group） and 183 patients 〈65 years of age（the younger group）,were analyzed.Prognosis factors were determined through univariate and multivariate analysis.Results：A lower ratio of the elderly group underwent secondary cytoreduction（8.7% compared to 24.6%;P=0.0018） in comparison to the ratio in the younger group.The median overall survival from recurrence was 35.6 months in the patients with secondary cytoreduction and 20.7 months in patients without secondary cytoreduction（P=0.02）.The elderly group frequently received more second line single agent platinum than platinum-combination chemotherapy（45.3% vs 22.1%,P=0.006）.Median overall survival from recurrence was 21.6 months in the patients with second line single agent platinum chemotherapy and 32.8 months for patients with platinum-combination chemotherapy.Median overall survival from recurrence was 31.2 months in the younger group and 23.7 months in the elderly group（P=0.165）.A multivariate analysis showed that the prognostic factors were independently related to age,stage,platinum-combination chemotherapy,performance status,progression-free time,number of diseased sites,and residue lesions of secondary cytoreduction at recurrence（P〈0.05）.Conclusion：Age,stage,platinum-combination chemotherapy,performance status,progression-free time,number of diseased sites,and residue lesions of secondary cytoreduction at recurren

关 键 词：卵巢肿瘤 复发 老年 

分 类 号：R737.31[医药卫生—肿瘤]