老年胃癌患者接受手术的新辅助化疗:基于人口的队列研究
Kammy Keywani1,2, Alexander B J Borgstein1,2, Wietse J Eshuis1,2
1Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
概括
新辅助化疗并没有显著改善75岁及以上胃癌患者的整体存活率. 然而,老年患者在接受新辅助化疗后更有可能不进行手术.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 手术瘤学手术瘤学
背景情况:
- 在胃癌中进行术后化疗的临床试验往往不包括老年患者,限制了概括性.
- 新辅助化疗在老年胃癌患者 (≥75岁) 的疗效和安全性仍然不确定.
研究的目的:
- 为了比较75岁以上的胃腺癌患者的生存结果,这些患者接受了或没有接受新辅助化疗.
- 检查老年患者与年轻患者的新辅助化疗后手术不进展的比率.
主要方法:
- 基于人口的回顾性队列研究.
- 对1995名胃腺癌患者 (2015-2019) 的分析,比较了与或没有新辅助化疗治疗的75岁以上患者的结果.
- 根据年龄 (<75岁与≥75岁) 评估手术不进展率.
主要成果:
- 在接受新辅助化疗 (中位数为34.9个月) 或不接受新辅助化疗 (中位数为32.3个月) 的老年患者之间,总生存率没有显著差异.
- 与年轻患者 (8.9%) 相比,显著更高比例的老年患者 (15.6%) 在接受新辅助化疗后没有进行手术.
- 接受新辅助化疗的老年患者与没有接受新辅助化疗的老年患者之间的患者特征有显著差异.
结论:
- 在高度精选的老年胃癌患者中,新辅助化疗并没有改善整体存活率.
- 老年患者 (≥75岁) 在接受新辅助化疗后未能进行手术的比例更高.
- 在老年患者中,应谨慎使用新辅助化疗,并仔细选择那些可能受益的人.
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