老年恶性肿瘤患者术后化疗相关性贫血的临床分析  

Analysis of postoperative chemotherapy-related anemia in elderly cancer patients

作　　者：苏贺 张凌云[2] 刘云鹏[2] 

机构地区：[1]阜新矿业(集团)有限责任公司总医院肿瘤科,123000 [2]中国医科大学附属第一医院肿瘤内科

出　　处：《中华肿瘤杂志》2015年第4期290-292,共3页Chinese Journal of Oncology

摘　　要：目的分析术后化疗对t〉60岁恶性肿瘤患者血红蛋白水平的影响。方法收集术后病理确诊为恶性肿瘤、血红蛋白≥120g／L、美国东部肿瘤协作组评分为0—2分的157例恶性肿瘤患者的临床资料，分析胃肠道恶性肿瘤和乳腺癌患者1、3、5个周期化疗后，以及肺癌患者1、2、3个周期化疗后贫血的发生情况。结果157例患者化疗后贫血的发生率为31．8％（50／157），根据美国国家癌症研究所通用不良反应事件术语标准（CTCAE）4．0版，其中CTCAE1级占全部贫血人数的94．0％（47／50），CTCAE2级占4．0％（2／50），CTCAE3级占2．0％（1／50）。男性患者化疗后贫血的发生率为18．8％，女性患者为47．2％，差异有统计学意义（P〈0．001）。完成3个周期化疗的肺癌患者贫血的发生率为57．9％，乳腺癌为34．5％，胃癌为26．3％，结直肠癌为9．3％，差异有统计学意义（P〈0．001）。随着化疗周期的增加，恶性肿瘤患者贫血的发生率逐渐增加。应用NP（长春瑞滨联合顺铂）方案和单药长春瑞滨化疗的非小细胞肺癌患者贫血发生率分别为66．7％和25．0％，差异有统计学意义（P=0．044）。结论血红蛋白水平正常、身体状态较好的老年恶性肿瘤患者化疗耐受性好，化疗相关性贫血的发生率较低，且多为轻度。对于老年、女性肺癌患者，应用多周期含铂方案化疗后应警惕贫血的发生。Objective This study was conducted to investigate the correlation between anemia and postoperative chemotherapy in elderly cancer patients. Methods One hundred and fifty-seven elderly patients （age ≥60） with pathologically confirmed breast, lung and digestive tract cancers, who had HGB ≥ 120 g/L and ECOG scores 0-2, were included in this study. We reviewed their elinicopathologieal data and analyzed the correlation of anemia in breast cancer patients after 1, 3 or 5 cycles and lung cancer patients after 1, 2 or 3 cycles of postoperative chemotherapy. Results Among the 157 cases, the overall proportion of anemia was 31.8% （50/157）, with 18.8% in male and 47.2% in female patients （P〈O.001）. After three cycles of chemotherapy, the proportion of anemia was 57.9% in lung cancer, 34.5% in breast cancer, 26.3% in gastric cancer and 9.3% in colorectal cancer patients （P〈0.001）. The proportion of anemia during 5 cycles chemotherapy （three cycles in lung cancer） was gradually increasing. In the lung cancer patients, anemia was observed in 66.7% of patients who received vinorelbine plus eispiatin regimen and 25.0% of cases who received vinorelbine regimen chemotherapy （P = 0.044）. Conclusions In most elderly patients with normal hemoglobin level and in good conditions, the chemotherapy-related anemia is mild and less frequent. Age should not limit the adjuvant chemotherapy in elderly cancer patients. Attention should be paid to the possibility of anemia in elderly female lung cancer patients receiving muhiple cycle platinum-based chemotherapy regimens.

关 键 词：老年人 肿瘤 抗肿瘤联合化疗方案 贫血 

分 类 号：R730.5[医药卫生—肿瘤]