在老年患有转移性胰腺癌的成年人中,化疗和支持性护理实践模式
Charles E Gaber1,2, Abdullah I Abdelaziz1, Ida R Johannsen3,4
1Department of Pharmacy Systems, Outcomes and Policy, Retzky College of Pharmacy, University of Illinois Chicago, Chicago, IL.
JCO oncology practice
|October 16, 2025
概括
在老年人中转移性胰腺癌的化疗已经从格米西塔单一疗法转向组合疗法,如格米西塔与纳布-帕克利塔塞尔 (GnP) 和FOLFIRINOX. 治疗选择因患者的脆弱性而有很大差异.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 转移性胰腺管腺癌 (mPDAC) 是癌症死亡的一个重要原因.
- 对mPDAC的确立的第一线化疗选择包括FOLFIRINOX和gemcitabine与nab-paclitaxel (GnP).
- 患有mPDAC的老年人治疗模式尚不清楚.
研究的目的:
- 分析老年人mPDAC的第一线化疗选择的国家趋势.
- 确定影响该群体化疗方案选择的因素.
- 检查老年人与mPDAC.接受二线治疗的情况.
主要方法:
- 使用SEER-Medicare链接数据库 (2010-2019) 对66岁以上被诊断患有mPDAC的队列.
- 评估了第一线治疗选择的时间趋势,按脆弱指数分层.
- 采用多项逻辑回归来确定患者因素与治疗选择之间的关联.
主要成果:
- 单独治疗吉米西塔的比例从2010年的69.3%下降到2019年的16.6%,而GnP增加到45.2%,FOLFIRINOX增加到20.9%.
- 2019年FOLFIRINOX的使用率在健壮个体中为29.8%,在脆弱个体中为19.8%,在脆弱个体中为6.8%.
- 年龄,性别,种族/民族,并发症和虚弱与治疗方案的选择有关;顺序治疗是常见的.
结论:
- 对于患有mPDAC的老年人来说,化疗的利用已经演变,治疗方案偏好发生了显著的转变.
- 治疗选择在基线脆弱性的不同水平之间显示出显著的差异.
- 需要进行进一步的研究,以优化对患有mPDAC.的老年人群的化疗选择.
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