弱体能状态晚期消化道恶性肿瘤患者低剂量化疗效果及预后因素分析  

Analyses of low-dose chemotherapy effect and prognostic factors in advanced gastrointestinal cancer patients with weak physical condition

作　　者：张秀萍 李芳 李智勇 苏志敏 王志明 Zhang Xiuping;Li Fang;Li Zhiyong;Su Zhimin;Wang Zhiming(Department of Medical Oncology,Xiamen Branch,Zhongshan Hospital,Fudan University,Xiamen 361015,China)

机构地区：[1]复旦大学附属中山医院厦门医院肿瘤内科,福建厦门361015

出　　处：《肿瘤研究与临床》2021年第2期114-118,共5页Cancer Research and Clinic

摘　　要：目的探讨低剂量化疗对弱体能状态晚期消化道恶性肿瘤患者的临床治疗效果,并评价影响预后的因素。方法回顾性分析2018年3月至2019年5月复旦大学附属中山医院厦门医院收治的118例弱体能状态晚期消化道恶性肿瘤患者的临床资料。采用Kaplan-Meier法对各因素分层患者进行生存分析,并行log-rank检验;采用Cox回归模型进行预后多因素分析,评价各临床病理因素与预后的关系。结果 118例患者中,食管癌16例(13.6%),胃癌41例(34.7%),结直肠癌48例(40.7%),胰腺癌13例(11.0%)。全组6个月、1年的总生存(OS)率分别为44.1%、10.2%。生存分析显示,血红蛋白≥ 100 g/L、血清清蛋白>40 g/L及胃肠道功能正常者OS较好(均P<0.05),体能状态评分3分及伴疼痛患者OS较差(均P<0.05)。Cox多因素分析显示,校正年龄、性别后,血红蛋白水平(HR=0.314,95%CI 0.241~0.977,P=0.001)、疼痛(HR=2.016,95%CI 1.697~7.038,P=0.008)及胃肠道功能(HR=1.751,95%CI 1.607~6.080,P=0.036)是接受低剂量化疗的弱体能状态晚期消化道恶性肿瘤患者OS独立影响因素。结论弱体能状态晚期消化道恶性肿瘤患者仍可从低剂量化疗中获益,血红蛋白水平、疼痛和胃肠道功能是此类患者的独立预后影响因素。Objective To investigate the clinical therapeutic effect of low-dose chemotherapy in advanced gastrointestinal cancer patients with weak physical condition,and to evaluate the related factors affecting the prognosis.Methods The clinical data of 118 advanced gastrointestinal cancer patients with weak physical condition who were admitted to Xiamen Branch,Zhongshan Hospital,Fudan University from March 2018 to May 2019 were retrospectively analyzed.Kaplan-Meier method was used to make survival analysis in patients stratified by different factors,and log-rank was used to test.Multiple factor analysis of prognosis was performed by using Cox regression model.The association of clinicopathological factors with the prognosis was evaluated.Results Among 118 patients,16(13.6%)cases were esophageal cancer,41(34.7%)cases were gastric cancer,48(40.7%)cases were colorectal cancer,13(11.0%)cases were pancreatic cancer.The overall survival(OS)rates of 6 months and 1-year were 44.1%and 10.2%,respectively.Survival analysis showed that patients with hemoglobin≥100 g/L,serum albumin>40 g/L and normal gastrointestinal function had better OS(all P<0.05),while patients with physical status score of 3 scores and pain had worse OS(all P<0.05).Cox multivariate analysis showed that after adjusting age and gender,hemoglobin level(HR=0.314,95%CI 0.241-0.977,P=0.001),pain(HR=2.016,95%CI 1.697-7.038,P=0.008)and gastrointestinal function(HR=1.751,95%CI 1.607-6.080,P=0.036)were independent influencing factors of OS in advanced gastrointestinal cancer patients with weak physical condition after receiving low-dose chemotherapy.Conclusions Low-dose chemotherapy can still benefit advanced gastrointestinal cancer patients with weak physical condition.Hemoglobin level,pain and gastrointestinal function are independent prognostic factors for these patients.

关 键 词：消化系统肿瘤 低剂量化疗 弱体能状态 

分 类 号：R735[医药卫生—肿瘤]