影响老年胰腺癌预后的多因素分析

Multple Factors Analysis of Elderly Patients with Pancreatic Carcinomas

目的：探讨影响老年胰腺癌预后的因素。方法：回顾分析天津市肿瘤医院2004年1月—2012年12月收治的老年胰腺癌病例（年龄≥65岁）121例,随访至2013年1月者121例。应用Kaplan-Meier法计算生存率,生存曲线采用Log-rank检验,多因素分析采用COX比例风险模型。结果：121例患者生存期为1～19个月,中位生存期（6.0±2.3）个月,其中6个月、12个月、18个月生存率分别为51.2%、13.3%、4.1%。多因素分析显示,手术方式、化疗、对症支持治疗是影响胰腺癌预后的独立因素。结论：老年胰腺癌患者由于对手术、放化疗耐受能力差,往往由于各种原因不能进行常规的治疗,所以应根据老年人个体条件的不同行个体化治疗。最终目的是在尽可能根治的前提下,延长生存时间,提高生活质量。

ObjectiveTo explore the major prognostic factors in old patients with pancreatic carcinoma.MethodsOne hundred and twenty-one patients with pancreatic carcinoma from 2004 to 2012 choosed fromTianjin Medical University Cancer Hospital were reviewed. Survival rate was caculated by Kaplan-Meier estima-tion while survival curve was analysed by log-rank test. Prognostic factors were studied by multivariate analysiswith COX proportional hazards survival model.ResultsIn this group, the survival time was 1 to 19 monthsand the median survival time was（6.0 ±2.3） months. The overall survival rates at 6 months, 12 months, 18 months were 51.2%, 13.3%, and 4.1% respectively. Multivariate analysis revealed that independent prognosticfactors were TNM tumor staging, sugical mode, chemotherapy, symptomatic and supportive therapy.Conclusion Elderly patients with pancreatic cancers always have poor ability for tolerance with surgery, radiation and che-motherapy. Becasuse of various reasons, they were not suitable to conventional treatment. They should be individ-ually treated according to the conditions of the elderly individual. The ultimate aim was to offer a radical cure asmuch as possible under the premise of prolonging the survival time and improving the quality of life.