老年进展期胃癌患者预后影响因素分析

Prognostic factors analysis of the elderly patients with advanced gastric cancer

目的探讨老年进展期胃癌患者预后影响因素分析。方法对武警广西总队医院诊断、治疗的174例进展期胃癌患者相关治疗进行分析，患者均接受化疗治疗，对患者生存进行分析，并对患者进行多因素研究，分析老年进展期胃癌患者治愈后相关因素。结果174例患者均进行一线化疗，其中160例至少接受2个周期化疗，12例1周期后拒绝治疗，未评价疗效，162例患者中RR为31．5％（51／162），DCR为73．5％（119／162）；患者治疗后死亡率占81．6％，患者中位OS为11．4个月，患者1年生存率为39．0％，2年生存率为17．0％；两药方案中位0S多于单药方案（P〈0．05）；132例仅接受一线化疗患者中0S为10．7个月，42例接受二次化疗0S为16．7个月（P〈0．05）；经过Logistic回归分析结果显示：化疗周期数、进展后接受二线化疗、ECOG评分、转移个数、CEA、LDH、CA19-9均是影响进展期胃癌预后独立因素。结论胃癌发病率较高，老年进展期胃癌患者在多周期化疗以及一线化疗进展后进行二线化疗效果理想，值得推广使用。

Objective To investigate the progress of analysis of elderly patients with gastric cancer during the post cure related factors. Methods To diagnose and therapy in our hospital 174 cases of advanced gastric cancer patients were related to treatment were analyzed,the patients received chemotherapy in the treatment of patients,survival analysis,and multi factor analysis study of patients,cure gastric cancer in elderly patients after related factors. Results 174 patients were subjected to first-line chemotherapy,in which 160 patients received at least 2 cycles of chemotherapy,12 cases after 1 cycles of refuse treatment, not evaluation of curative effect, 162 patients of RR was 31.5% （51/162）, DCR 73. 5 % （119/162） ; mortality accounted for 81. 6% of patients after the treatment, patients with a OS of 11.4 month,patients 1 years survival rate was 39% ,2 year survival rate was 17% ;the two regimens OS more than single agent chemotherapy（P〈0.05）; 132 cases only received first-line chemotherapy in patients with OS was 10.7 months,42 patients received two cycles of chemotherapy with OS for 16.7 months（P%0.05） after Logistic regression analysis;the results showed：the number of chemotherapy cycles, progress after second-line chemotherapy, ECOG score,number of metastatic, CEA, LDH, CA19-9 are the impact of advanced gastric cancer after cure inde- pendent factors. Conclusion The incidence of gastric cancer is higher, the elderly patients with advanced gastric cancer were the ideal effect of chemotherapy in progress of second-line multi cycle chemotherapy and after first-line chemotherapy, can improve the prognosis of patients,is worthy to be popularized.