高龄结直肠癌患者术后化疗依从性的影响因素分析

Factors Affecting Compliance of Postoperative Chemotherapy for Elderly Patients with Colorectal Cancer

目的探讨高龄结直肠癌患者术后化疗的依从性及其影响因素。方法回顾性分析115例高龄结直肠癌患者的临床病例资料,其中65例接受术后辅助化疗,50例拒绝了术后化疗。对影响高龄结直肠癌患者术后化疗依从性的客观因素进行Logistic回归分析,并电话随访拒绝化疗患者的主观因素。结果多因素分析显示,性别、BMI、BSA、年龄及并发症是影响患者化疗依从性的独立因素(均P<0.05)。主观因素方面,有12例(60.0%)Ⅱ期结直肠癌患者拒绝化疗是因为医生的建议程度不够。患者的恐惧心理(20.0%,3/15)、经济条件(20.0%,3/15)及对预后的绝望情绪(27.3%,3/11)是影响Ⅲ、Ⅳ期患者接受化疗的主要原因。结论患者的性别、BMI、BSA、年龄、并发症是影响高龄结直肠癌术后化疗依从性的客观指标。对于Ⅱ期患者,医生对化疗的建议程度应该加强;对于Ⅲ期患者,应调节患者负性情绪。

Objective To investigate the compliance of postoperative chemotherapy for elderly patients with colorectal cancer and influence factors. Methods Clinicopathological data of 115 elderly patients（ 〉70 years old） with stage II - IV colorectal cancer were retrospectively reviewed. 65 cases received postoperative chemotherapy and 50 refused. Logistic regression mod- el was used to analyze factors affecting compliance of postoperative chemotherapy. Patients were followed up by phone call regarding the reason for refusal. Results Multivariate analysis showed that gender, body mass index（ BMI）, body surface area（ BSA）, age and complication were independent risk factors associated with chemotherapy compliance （ All P 〈 0.05 ）. Follow-up phone questionnaire showed that 12（60.0% ）patients with stage II colorectal cancer did not receive chemotherapy because the doctor did not offer sufficient advice. For stage III, IV patients, fear of chemotherapy（ 20.0% ,3/15 ）, financial issues （20.0%, 3/15 ） and desperate feelings about prognosis（27.3% ,3/11 ） were the main factors affecting patients＇ receiving chemotherapy. Conclusions Gender, BMI, BSA, age and complications are the main factors associated with compliance of postoperative chemotherapy. Doctors＂ recommendation should be emphasized for stage II patients. For stage III patients, patients＂ negative emotions should be adjusted.