胃癌老年患者的辅助化疗:基于人口的队列研究
Wing-Lok Chan1, Xiaodong Liu2, Carlos King-Ho Wong3
1Department of Clinical Oncology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
辅助化疗显著改善了D2-胃切除术后II/III期胃癌的老年患者的整体生存率和癌症特异性生存率. 这种生存益处在不同年龄组中观察到,包括80岁以上的年龄组.
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D2-胃切除术后的老年胃癌患者中,辅助化疗的作用仍然不确定.
- 胃癌影响着大量老年人群,需要量身定制的治疗策略.
研究的目的:
- 为了研究辅助化疗在老年患者 (≥65岁) 胃癌II/III期的疗效.
- 为了比较接受辅助化疗和单独手术的老年胃癌患者的整体生存率 (OS) 和癌症特异性生存率 (CSS).
主要方法:
- 来自香港医院管理局数据库 (1997-2020) 的2616名老年患者 (第二/第三期胃癌) 的回顾性队列研究.
- 在接受辅助化疗的732名患者和仅接受手术的732名患者之间,倾向性得分匹配 (PSM) 均衡的特征.
- 考克斯比例危险回归分析了使用危险比率 (HR) 的OS和CSS.
主要成果:
- 与单独进行手术相比,辅助化疗改善了OS (37 vs. 25个月;HR:0.80;p < 0.001).
- 在65-80 (HR:0.79) 和>80 (HR:0.82) 的年龄组中,OS的好处一致.
- 辅助化疗也证明了改善的CSS (5年CSS:64.1%对61.1%;HR:0.85;p <0.001).
结论:
- 辅助化疗在患有II/III期胃癌的老年患者中显著改善了OS和CSS.
- 这些发现支持在老年胃癌患者中使用辅助化疗,包括非常老年人 (>80).
- 这项研究为优化胃癌老年瘤学辅助治疗策略提供了现实世界的证据.
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