改良老年疾病累计评分表在老年食管癌患者中的应用

Use of modified cumulative illness rating scale-geriatric in patients with esophageal cancer

目的应用改良老年疾病累计评分表(MCIRS-G)探讨老年食管癌患者合并症对化疗安全性的影响。方法90例接受DLF方案化疗的食管癌患者按年龄分为老年组(≥65岁)和对照组(<65岁)。采用MCIRS-G量表评估合并症,根据MCIRS-G得分、年龄、KPS评分来分层研究化疗毒副反应的发生率。结果老年组MCIRS-G得分明显高于对照组(P=0.000),随着MCIRS-G得分升高,老年组中提示血液学毒性(P=0.016)、肝肾功能损(P=0.034)、疲劳(P=0.037)的发生率显著增加,化疗安全性降低。但根据年龄和KPS评分未发现化疗安全性明显降低。结论MCIRS-G量表能全面地评价老年食管癌患者合并症,其得分与不良事件发生率呈正相关。MCIRS-G评分在预测化疗毒副反应方面比KPS,年龄更灵敏。

Aim To investigate comorbidities in elderly patients with esophageal cancer on the effects of chemotherapy safety by the modified cumulative illness rating scale-geriatric （MCIRS-G）. Methods 90 patients with esophageal cancer treated with DLF regimen chemotherapy were divided into the elder group（ ≥65 years） and the control group （ 〈 65 years ）. Comorbidity was assessed with the modified cumulative illness rating scale-geriatric. According to the score of MCIRS-G, age and karnofsky performance score （KPS） the incidence of chemotherapy toxicity was studied. Results The score of MCIRS-G in the elderly group was significantly higher than that of the control group（ P = 0. 000）. With the score of MCIRS increasing, there was a significant increase in hematological toxicity （ P = 0. 016）, aggravation of liver and renal function （P = 0. 034 ）, and fatigue （P = 0. 037 ）, so the level of chemotherapy security was de- creased. However, according to age and KPS, the level of chemotherapy security was not significantly decreased. Conclusion The MCIRS-G could be used to evaluate comorbidity of the elderly patients with esophageal cancer comprehensively. The scores and the incidence of adverse events were positively correlated. It was more sensitive to predict chemotherapy toxicity according the score of MCIRS-G than KPS and age.