对老年患有晚期胆道癌症的单疗法和联合疗法进行比较:一项回顾性研究
Ritsuko Oishi1,2, Satoshi Kobayashi3, Shuhei Nagashima1
1Department of Gastroenterology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-ku, Yokohama City, 241-0815, Kanagawa, Japan.
对于晚期胆道癌症 (BTC) 的老年患者来说,组合化疗与单一治疗相比没有显示出更高的整体存活率. 治疗选择应根据患者的病情进行个性化选择,因为毒性是可以管理的.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 老年医学 老年医学
背景情况:
- 晚期胆道癌 (BTC) 的标准一线治疗方法是组合化疗.
- 在老年BTC患者中,组合治疗与单一治疗的有效性尚不清楚.
研究的目的:
- 在75岁以上的晚期BTC患者中,比较组合化疗与单疗的疗效和安全性.
主要方法:
- 对157名患者 (≥75岁) 进行了回顾性研究,这些患者患有不可切除或复发的BTC.
- 较量gemcitabine (GEM) + cisplatin或GEM + S-1 (组合) 与单独使用GEM或S-1 (单疗法).
- 评估患者的特征,生存率,不良事件和剂量强度.
主要成果:
- 单疗组的老年患者表现较差,表现状况较差,白蛋白水平较低.
- 平均整体存活期 (OS) 显示出有利于组合疗法的趋势 (16.4 vs 12.8 个月),但多变量分析没有证实优势 (HR 1.05).
- 组合组中≥3级不良事件的发生率较高 (79%对53%),但可管理的毒性和类似的断药率.
结论:
- 对于老年BTC患者来说,组合化疗绝对不推.
- 根据患者的病情进行个性化化疗选择至关重要.
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