结直肠癌老年患者的辅助化疗:日本的一项单中心观察性研究
Kazuaki Okamoto1, Hiroaki Nozawa1, Shigenobu Emoto1
1Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan.
Journal of chemotherapy (Florence, Italy)
|October 26, 2023
概括
辅助化疗有利于结直肠癌 (CRC) 患者,但老年患者接受的频率较低. 尽管如此,化学疗法无论年龄如何都显示出良好的结果,这凸显了需要改善其在老年CRC患者中的使用.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 老年病的医生 老年病的医生
背景情况:
- 辅助化疗是一种标准治疗方法,用于改善结直肠癌 (CRC) 患者在彻底切除后的预后.
- 老年患者往往在治疗耐受性和疗效方面存在独特的挑战,需要对辅助化疗方案进行具体考虑.
- 了解年龄对CRC辅助化疗的利用和有效性的影响,对于优化患者的治疗结果至关重要.
研究的目的:
- 评估老年结直肠癌 (CRC) 患者辅助化疗方案的疗效.
- 为了比较老年 (≥70岁) 和年轻 (<70岁) 的CRC患者之间辅助化疗的结果.
- 在不同年龄组的CRC患者中确定影响辅助化疗的使用和有效性的因素.
主要方法:
- 一项对1138名日本高风险II期或III期结直肠癌 (CRC) 患者的回顾性分析,这些患者于2010年7月至2021年6月期间进行了手术.
- 患者根据年龄分为两组:<70岁和≥70岁.
- 该研究分析了年龄,辅助化疗方案和结果之间的关联,包括癌症特异性生存率 (CSS) 和无复发生存率 (RFS).
主要成果:
- 与年轻患者相比,老年患者 (≥70岁) 在复发后接受辅助化疗或化疗的可能性明显低.
- 虽然70岁以下的III期CRC患者的CSS比70岁以上的患者长,但CSS在年龄组内的治疗方案之间没有显著差异.
- 辅助化疗与第三阶段CRC患者70岁以下的RFS更长时间有关;然而,无论年龄,都观察到它与CSS的有利关联.
结论:
- 在老年CRC患者中,辅助化疗的实施率较低可能导致他们的癌症特异性生存率较差.
- 辅助化疗对所有年龄组的结直肠癌患者的癌症特异性生存率产生了有利的影响.
- 在老年CRC患者中增加辅助化疗的利用策略是有必要的,以改善他们的长期预后.
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