XELOX方案治疗Ⅳ期胃癌患者行为状态评分的影响因素

The influential factors of Karnofsky Performance Status score of gastric cancer patients of stage Ⅳ receiving combination regimen with oxaliplatin plus capecitabine

目的探讨可能影响XELOX方案治疗的Ⅳ期胃癌患者Karnofsky评分的因素。方法回顾性分析2004年5月至2009年10月收治的采用奥沙利铂联合卡培他滨方案(XELOX方案)治疗的Ⅳ期胃癌患者共29例。记录患者背景(性别、年龄、吸烟史、医疗费用支付方式)、疾病情况(肿瘤部位、病理类型、分化程度、有无远处转移、化疗前CEA水平、血红蛋白水平)、治疗因素(体表面积、化疗药物剂量、疗程、白细胞水平)、营养情况(白蛋白、前白蛋白水平),并记录每次入院时Karnofsky评分,分析上述因素和Karnofsky评分有无关系。结果患者背景、疾病情况(血红蛋白水平除外)未显示出对Karnofsky评分有明显影响。不同药物剂量组化疗3周期及6周期后Karnofsky评分较初诊时改变无明显差异。XELOX方案化疗3、6周期后Karnofsky评分和初诊Karnofsky评分相比较无明显差异。白细胞、血红蛋白、白蛋白及前白蛋白水平和Karnofsky评分明显相关。结论自初诊至化疗6周期,XELOX方案治疗的Ⅳ期胃癌患者Karnofsky评分与白细胞、血红蛋白、白蛋白及前白蛋白水平有明显相关。患者背景、肿瘤部位、病理类型、分化程度、有无远处转移、化疗前CEA水平、化疗药物剂量、病程在本研究中未显示与Karnofsky评分明显相关,有待进一步研究。

Objective To investigate the influential factors of Karnofsky Performance Status score of gastric cancer patients of stage IV receiving combination regimen with oxaliplatin plus capecitabine.Methods Twenty-nine gastric cancer patients of stage IV were involved,who were admitted by oncology department of Peking Union Medical College Hospital and received the regimen of oxaliplatin plus capecitabine（XELOX regimen）.The data including patients background（sex,age,smoking history,the way of paying medical cost）,disease information（tumor location,pathology type,differentiation,the metastasis to distant place,CEA level before chemotherapy,hemoglobin level）,therapy information（surface area,drug dosage,course of treatment,leucocyte level）and nutrition condition（albumin,prealbumin level）were recorded.KPS score was assessed each time when the patient was admitted.The correlations between the above factors and KPS score were analysed.Results No correlations between patients background or disease information（except hemoglobin level）and KPS score were found in this study.There were no significant differences of KPS score in normal/low dosage groups after chemotherapy for 3 cycles and 6 cycles.Comparing KPS score first recorded with that after treatment for 3 and 6 cycles,and comparing the KPS score after 3 cycles with that after 6 cycles,no significant differences were found.The level of albumin,prealbumin,leucocyte and hemoglobin correlated with KPS score.Conclusion From the first admission to chemotherapy for 6 cycles,in the gastric cancer patients of stage IV who have received XELOX regimen,the level of albumin,prealbumin,leucocyte and hemoglobin correlate with KPS score.There are no correlations between patients′ background,tumor location,pathology type,differentiation,metastasis to distant place,CEA level before treatment,drug dosage,the course of disease and KPS score in this study.