晚期胃癌一线化疗失败的危险因素分析及干预措施

Risk factors for failure of first-line chemotherapy in advanced gastric cancer and intervention suggestions

目的:探讨晚期胃癌一线化疗失败的危险因素。方法:选择2015年10月—2019年10月收治的晚期胃癌患者123例,按照化疗是否失败分为化疗失败组(n=41)和化疗未失败组(n=82)。统计晚期胃癌患者一线化疗失败的情况,总结可能影响晚期胃癌患者一线化疗失败的相关危险因素,对比两组的不同特征情况;采用Logistic回归分析晚期胃癌患者一线化疗失败的影响因素。结果:发生一线化疗失败41例(33.33%);化疗失败组年龄>60岁、低分化程度、肿瘤淋巴结转移(TNM)分期为Ⅳ期、化疗前贫血、营养不良构成比均高于化疗未失败组(P<0.05),中医辅助治疗构成比低于化疗未失败组(P<0.05);年龄>60岁、低分化程度、TNM分期为Ⅳ期、化疗前贫血、营养不良均是晚期胃癌一线化疗失败的独立危险因素(P<0.05);中医辅助治疗是其保护因素。结论:晚期胃癌患者有一线化疗失败的风险,且年龄>60岁、低分化程度等均是其危险因素,中医辅助治疗是其保护因素,需加强防控并进行干预。

Objective:To explore the risk factors of failure of first-line chemotherapy for advanced gastric cancer.Methods:The clinical data of 123 patients with advanced gastric cancer admitted to hospital from October 2015 to October 2019 were retrospectively reviewed.The failure of first-line chemotherapy in patients with advanced gastric cancer was analyzed,and the patients were divided into failure group(n=41)and non-failure group(n=82)after first-line chemotherapy.The risk factors that may affect the failure of first-line chemotherapy in patients with advanced gastric cancer were summarized,andthe characteristics of different situations between the failure group and non-failure group were compared.Logistic regression analysis was used to explore theinfluencing factors of first-line chemotherapy failure in patients with advanced gastric cancer.Results:There were 41 cases of first-line chemotherapy failure in this group,the incidence was 33.33%.Age>60 years old,low differentiation,tumor node metastasis(TNM)stageⅣ,anemia and malnutrition before chemotherapy in the failure group were higher than those none-failure group(P<0.05).Chinese medicine adjuvant therapy was lower than those in none-failure group(P<0.05).Age>60 years old,low differentiation,TNM stageⅣ,anemia and malnutrition were risk factors for first-line chemotherapy failure in patients with advanced gastric cancer(P<0.05).Chinese medicine adjuvant therapy was a protective factor for the failure of first-line chemotherapy in patients with advanced gastric cancer(P<0.05).Conclusion:Patients with advanced gastric cancer have the risk of failure of first-line chemotherapy.Age>60 years old and low differentiation are risk factors.Chinese medicine adjuvant therapy is a protective factor.Prevention and control should be strengthened and intervention suggestions should be made.