可切除胃食道癌症的老年患者的术前化疗剂量减少:一项真实世界的数据研究
Josephine Skjoldbirk1, Kristian Egebjerg1, Camilla Qvortrup1
1Department of Oncology, Rigshospitalet, Denmark.
在手术前化疗中减少剂量可以改善胃食道癌症的老年患者 (≥70岁) 的整体存活率. 这种方法似乎是安全的和可行的,可能会提高这一群体的治疗结果.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 临床试验 临床试验
背景情况:
- 患有胃食道癌症的老年患者面临较高的治疗耐受性和治疗结果差的风险.
- 降低剂量化疗在晚期已显示出有效性,但其在老年人手术前环境中的作用尚不清楚.
研究的目的:
- 研究手术前化疗剂量降低对患有可切除胃食道癌症的老年患者 (≥70岁) 存活时间的影响.
主要方法:
- 一项对548名接受外科手术期间化疗的患者的队列研究 (2016年11月至2021年10月).
- 总生存率 (OS) 是主要终点,使用Kaplan-Meier和日志等级测试进行分析.
- 多变量分析对共变量进行控制.
主要成果:
- 老年患者 (≥70) 更有可能接受剂量降低的化疗 (37%vs14%).
- 后期周期的剂量减少与老年患者显著改善的生存状况 (HR=0.54,p=0.006) 和较低的死亡风险 (HR=0.56,p=0.04) 相关.
- 较年轻的患者从剂量减少中没有显示出生存益处.
结论:
- 在术前化疗中降低剂量似乎对患有胃食道癌症的老年患者来说是安全的和可行的.
- 这种策略可以改善整体存活率,而不会影响疗效.
- 建议在独立队列或随机试验中进一步验证.
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