發(fā)布時間：2018-05-18 01:33

  本文選題：結(jié)直腸腫瘤 + 轉(zhuǎn)移性��； 參考：《腫瘤》2017年03期

【摘要】：目的:探討一線化療劑量強度對晚期轉(zhuǎn)移性結(jié)直腸癌患者疾病控制率和總生存的影響。方法:回顧性分析2012年3月—2015年12月于天津醫(yī)科大學(xué)腫瘤醫(yī)院接受一線FOLFOX方案化療的37例轉(zhuǎn)移性結(jié)直腸癌患者的臨床資料。根據(jù)患者化療情況,分別以80%、75%及85%作為一線奧沙利鉑相對劑量強度(relative dose intensity,RDI)、一線5-氟尿嘧啶RDI以及平均RDI(average RDI,ARDI)的分界值。單因素生存分析采用Kaplan-Meier法,并進(jìn)行l(wèi)og-rank檢驗。多因素生存分析采用COX回歸模型。結(jié)果:一線奧沙利鉑RDI≥80%組、一線5-氟尿嘧啶RDI≥75%組以及ARDI≥85%組的DCR分別高于相應(yīng)的一線奧沙利鉑RDI80%組、一線5-氟尿嘧啶RDI75%組以及ARDI85%組,但差異均無統(tǒng)計學(xué)意義(P值均0.05)。單因素分析結(jié)果顯示,年齡、后續(xù)手術(shù)治療、后續(xù)除手術(shù)以外的化療、一線奧沙利鉑RDI、一線5-氟尿嘧啶RDI以及化療前血清糖類抗原19-9是影響患者總生存的預(yù)后影響因素(P值均0.05);而患者性別、美國東部腫瘤協(xié)作組體能狀況(Eastern Cooperative Oncology Group performance status,ECOG PS)評分、化療前并發(fā)癥、原發(fā)部位、淋巴結(jié)轉(zhuǎn)移、肝轉(zhuǎn)移、腹膜轉(zhuǎn)移、轉(zhuǎn)移器官數(shù)目、ARDI、化療前血清白蛋白水平和化療前血清癌胚抗原水平對患者總生存無顯著影響(P值均0.05)。多因素分析結(jié)果顯示,后續(xù)手術(shù)治療、后續(xù)除手術(shù)以外的化療和一線奧沙利鉑RDI是影響患者總生存的獨立預(yù)后因素(P值均0.05)。結(jié)論:一線奧沙利鉑RDI是影響轉(zhuǎn)移性結(jié)直腸癌患者預(yù)后的獨立因素,一線奧沙利鉑RDI≥80%者的總生存獲益更為顯著,此為晚期結(jié)直腸癌的規(guī)范化療提供了方向。
[Abstract]:Objective: to investigate the effect of dose intensity of first-line chemotherapy on disease control rate and total survival of patients with advanced metastatic colorectal cancer. Methods: the clinical data of 37 patients with metastatic colorectal cancer received first-line FOLFOX regimen chemotherapy in Tianjin Medical University Oncology Hospital from March 2012 to December 2015 were retrospectively analyzed. According to the patient's chemotherapy condition, 75% and 85% of the patients were used as the demarcation values of the relative dose intensity of oxaliplatin, the first-line 5-fluorouracil RDI and the average RDI(average RDI, respectively. Single factor survival analysis was performed with Kaplan-Meier method and log-rank test. COX regression model was used for multivariate survival analysis. Results: the DCR of the first-line oxaliplatin RDI 鈮，

本文編號：1903807