合并症而非年龄是接受吉西他滨为基础化疗的晚期胰腺癌患者的预后因素。
Comorbidity, not age, is prognostic in patients with advanced pancreatic cancer receiving gemcitabine-based chemotherapy.
机构信息
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan.
出版信息
Crit Rev Oncol Hematol. 2011 Jun;78(3):252-9. doi: 10.1016/j.critrevonc.2010.05.007. Epub 2010 Jun 25.
OBJECTIVE
To evaluate the impact of age and comorbidity on clinical outcomes in advanced pancreatic cancer.
METHODS
Consecutive 237 patients with advanced pancreatic cancer were studied. Comorbidity was scored by Charlson comorbidity index (CCI). We compared the clinical outcomes by age or comorbidity.
RESULTS
Sixty-nine patients were elderly (≥75 years), and CCI was 0 in 69 patients, 1 in 98, and ≥2 in 70. Gemcitabine-based chemotherapy was administered in 183 patients and was well tolerated in both elderly group and in those with comorbidities. In a multivariate analysis, CCI, not age, was prognostic in addition to PS, distant metastasis, chemotherapy and CA19-9: the hazard ratios of CCI 1 and ≥2 were 1.25 and 1.55, compared with CCI 0 (p=0.027).
CONCLUSIONS
Gemcitabine-based chemotherapy can be an effective treatment, without significant toxicity, in elderly patients. Comorbidity, not age, was prognostic in patients with advanced pancreatic cancer.
目的
评估年龄和合并症对晚期胰腺癌临床结局的影响。
方法
连续纳入 237 例晚期胰腺癌患者。采用 Charlson 合并症指数（CCI）对合并症进行评分。比较了不同年龄和合并症患者的临床结局。
结果
69 例患者年龄较大（≥75 岁），69 例患者 CCI 为 0，98 例患者 CCI 为 1，70 例患者 CCI≥2。183 例患者接受了吉西他滨为基础的化疗，在老年组和合并症患者中均具有良好的耐受性。多因素分析显示，CCI 而非年龄与 PS、远处转移、化疗和 CA19-9 一起是预后因素：CCI 为 1 和≥2 的危险比分别为 1.25 和 1.55，与 CCI 为 0 相比（p=0.027）。
结论
吉西他滨为基础的化疗对老年患者是一种有效且毒性较小的治疗方法。在晚期胰腺癌患者中，合并症而非年龄是预后因素。
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