Musculoskeletal Oncology Department, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
World J Surg Oncol. 2012 Sep 17;10:191. doi: 10.1186/1477-7819-10-191.
We sought to determine whether suboptimal chemotherapy compromised the prognosis of osteosarcoma patients.
A total of 132 eligible patients who underwent chemotherapy between 1998 and 2008 were identified in our database. Information regarding patient demographics, clinical characteristics, and survival status were extracted for analysis. Optimal chemotherapy was defined as receipt of ≥80% of the planned dose intensity of prescribed agents within the planned durations.
The use of optimal chemotherapy resulted in an overall survival benefit with P = 0.006. Patients who failed to complete the optimal chemotherapy protocol had a dismal prognosis of 30.8% overall survival over five years, whereas those who completed the optimal chemotherapy had an overall survival rate over five years of 65.3%. Based on multivariate analysis, patients who were treated with a suboptimal protocol had a higher risk of relapse, metastasis and mortality. The hazard ratio (HR) of recurrence or death for the suboptimal chemotherapy group was as high as 2.512 over that of the optimal chemotherapy group (HR = 2.512, 95% confidence interval = 1.242 to 3.729).
Chemotherapy is a significant independent prognostic variable, and suboptimal chemotherapy was found to have a detrimental effect on the outcome of patients with osteosarcoma.
我们试图确定化疗不充分是否会影响骨肉瘤患者的预后。
从我们的数据库中确定了 1998 年至 2008 年间接受化疗的 132 名符合条件的患者。提取了有关患者人口统计学、临床特征和生存状况的信息进行分析。优化化疗定义为在计划的持续时间内接受≥规定药物计划剂量强度的 80%。
使用优化化疗可带来整体生存获益，P=0.006。未能完成优化化疗方案的患者五年总体生存率仅为 30.8%，而完成优化化疗方案的患者五年总体生存率为 65.3%。基于多变量分析，接受不充分方案治疗的患者复发、转移和死亡的风险更高。与接受优化化疗方案的患者相比，接受不充分化疗方案的患者复发或死亡的风险比（HR）高达 2.512（HR=2.512，95%置信区间=1.242 至 3.729）。
化疗是一个重要的独立预后因素，不充分的化疗会对骨肉瘤患者的预后产生不利影响。
