联合化疗方案治疗老年晚期胃癌的临床疗效和安全性分析

Efficacy and safety analysis of combination chemotherapy for elderly patients with advanced gastric cancer

目的探讨临床常用晚期胃癌联合化疗方案治疗老年胃癌的临床疗效和安全性。方法回顾性研究2010年1月至2012年12月期间一线接受联合化疗的老年（年龄≥65岁）晚期胃癌患者20例。化疗2月后评价疗效,化疗期间监测药物毒性反应,对无进展生存时间（PFS）和总生存期（OS）进行随访。结果接受联合化疗的老年胃癌患者客观缓解率为15%,疾病控制率为90%,中位PFS和OS分别为6月和20.1月;分层分析显示仅肿瘤分期与患者PFS（P〈0.01）和OS（P〈0.01）显著相关,与年龄（≤75岁vs〉75岁）或化疗方案无关;化疗期间全部Ⅲ~Ⅳ度药物毒性反应的发生率为35%。结论采用联合化疗方案治疗晚期老年胃癌患者毒性反应在可耐受范围内,并可带来生存获益,方案和剂量的选择值得进一步临床研究。

Objective To investigate the clinical efficacy and safety of commonly used combination chemotherapy in the treatment of advanced gastric cancer in the elderly patients. Methods Twenty patients with advanced gastric cancer aged ≥65 years were recruited in this retrospective study. Patients were treated with first-line combination chemotherapy.Clinical response was evaluated after two months of treatment. Drug-related toxicity was monitored during chemotherapy.Progression-free survival time（PFS） and overall survival time（OS） were reported. Results The objective response rate was 15% and the disease control rate was 90%,median PFS and OS were 6 months and 20. 1 months,respectively. Stratified analysis showed that PFS（P〈0. 01） and OS（P〈0. 01） were significantly associated with tumor stage,but not with age（≤75 vs 〉75） or chemoregimens. All Ⅲ-Ⅳ degree toxicity observed was 35% and were manageable. Conclusions The combination chemotherapy offers survival benefit for elderly patients with advanced gastric cancer with tolerable toxicities. Further investigations of optimized regimens and dosage should be carried out to guide the management of gastric cancer in the elderly patients.