老年Ⅲ期结肠癌根治术后辅助化疗临床获益分析

Analysis on clinical benefit induced by adjuvant chemotherapy for elderly patients with stage Ⅲ colon cancer after radical resection surgery

目的:探讨老年Ⅲ期结肠癌患者根治术后辅助化疗的临床获益。方法:回顾性分析210例Ⅲ期结肠癌根治术后患者行术后辅助化疗的情况,包括老年组(≥65岁)107例和非老年组(<65岁)103例。比较老年组接受化疗者与未接受化疗者在无病生存和复发、转移方面的差异,同时比较老年组和非老年组患者接受化疗后的不良反应、无病生存(disease-freesur-vival,DFS)、复发和转移的差异。结果:老年组中接受化疗者的3年复发和转移率均明显低于未化疗者(28.8%和47.3%,P<0.05),中位DFS时间也明显优于后者(分别为17个月和12个月,P<0.05)。老年组接受化疗后的不良反应发生率及其严重度与非老年组比较无明显差异,同时在降低复发和转移率以及改善DFS时间方面与非老年组一致。结论:老年Ⅲ期结肠癌根治术后进行辅助化疗可以降低复发和转移率,并改善无病生存,不良反应也可耐受。

Objective：To explore the clinical benefit of adjuvant chemotherapy in elderly patients with stage Ⅲ colon cancer after radical resection surgery. Methods：This study retrospectively analyzed the clinical data from 210 patients who had stage Ⅲ colon cancer and received radical resection surgery. They were divided into elderly group （≥ 65 years, n=107） and non-elderly group （〈65 years, n=103）.This study compared the difference in disease-free survival, relapse, and metastasis between the patients who received adjuvant chemotherapy and those who did not receive adjuvant chemotherapy in elderly group. Then we compared the difference in adverse reaction, disease-free survival, and tumor relapse and metastasis rate between elderly group and non-elderly group.Results：The relapse and metastasis rates during the three years were significantly lower in patients who received the adjuvant chemotherapy than those who did not receive the adjuvant chemotherapy （28.8% vs 47.3%, P〈0.05）. The median disease-free survival was also superior to those who did not receive the adjuvant chemotherapy （17 months vs 12 months, P〈0.05）. There were no significant differences in occurrence frequency and severity of adverse reaction between the elderly and non elderly groups. The relapse and metastasis rates were decreased and the disease-free survival was improved in elderly group who received adjuvant chemotherapy, which was the same as the non-elderly group. Conclusion：Adjuvant chemotherapy reduced the relapse and metastasis rates and improved the disease free survival in elderly patients with stage Ⅲ colon cancer after radical resection surgery. The adverse reaction could be tolerated.