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含奥沙利铂辅助化疗对印度尼西亚日惹市萨迪托博士医院结肠癌患者短期生存的影响。

Effects of oxaliplatin-containing adjuvant chemotherapy on short-term survival of patients with colon cancer in Dr. Sardjito Hospital, Yogyakarta, Indonesia.

作者信息

Wardhani Yulia, Hutajulu Susanna Hilda, Ferianti Via Wahyu, Fitriani Zakia, Taroeno-Hariadi Kartika Widayati, Kurnianda Johan

机构信息

Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia.

Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia.

出版信息

J Gastrointest Oncol. 2019 Apr;10(2):226-234. doi: 10.21037/jgo.2018.12.10.

Abstract

BACKGROUND

Oxaliplatin-based adjuvant chemotherapy has been applied as standard treatment for high risk stages II and III colon cancer in many countries. There was no comprehensive report of oxaliplatin use in Indonesia. This research aimed to evaluate the short-term survival of patients with colon cancer treated with such strategy and the prognostic factors.

METHODS

Medical records of patients with colon cancer receiving oxaliplatin-containing adjuvant chemotherapy were retrospectively reviewed. Demography, clinicopathological, and treatment data were collected. Two-year overall survival (OS) and disease-free survival (DFS) were calculated using Kaplan-Meier method and survival predictors were estimated using Cox proportional hazard models.

RESULTS

Data of 81 patients had been included with a median follow-up of 25.2 months. The estimated OS and DFS at 2 years were 75.8% and 72.7%. In multivariate analyses, the Eastern Cooperative Oncology Group (ECOG) 2 performance status [hazard ratio (HR) =2.967; 95% confidence interval (CI), 1.265 to 6.957; P=0.012], T4 stage (HR =2.669; 95% CI, 1.087 to 6.557; P=0.032), and less cycles of chemotherapy administration (HR =3.280; 95% CI, 1.333 to 8.070; P=0.010) were significant independent factors for an increased risk of death. Cases with moderately to poorly differentiated tumors had significantly worse DFS compared with those with well differentiated tumors (HR =3.503; 95% CI, 1.403 to 8.744; P=0.007).

CONCLUSIONS

Colon cancer patients receiving oxaliplatin-based adjuvant regimens in our clinical practice had 2-year OS rate of 75.8% and 2-year DFS rate of 72.7%. ECOG 2 performance status, T4 stage, and less cycles of chemotherapy administration significantly predicted a poor OS and moderately to poorly histological grade significantly predicted a poor DFS.

摘要

背景

在许多国家,基于奥沙利铂的辅助化疗已被用作高危II期和III期结肠癌的标准治疗方法。印度尼西亚尚未有关于奥沙利铂使用情况的综合报告。本研究旨在评估采用该策略治疗的结肠癌患者的短期生存率及预后因素。

方法

回顾性分析接受含奥沙利铂辅助化疗的结肠癌患者的病历。收集人口统计学、临床病理和治疗数据。采用Kaplan-Meier法计算两年总生存率(OS)和无病生存率(DFS),并使用Cox比例风险模型估计生存预测因素。

结果

纳入81例患者的数据,中位随访时间为25.2个月。两年的OS和DFS估计值分别为75.8%和72.7%。在多变量分析中,东部肿瘤协作组(ECOG)2级体能状态[风险比(HR)=2.967;95%置信区间(CI),1.265至6.957;P=0.012]、T4期(HR =2.669;95%CI,1.087至6.557;P=0.032)以及化疗周期较少(HR =3.280;95%CI,1.333至8.070;P=0.010)是死亡风险增加的显著独立因素。与高分化肿瘤患者相比,中低分化肿瘤患者的DFS显著更差(HR =3.503;95%CI,1.403至8.744;P=0.007)。

结论

在我们的临床实践中,接受基于奥沙利铂辅助方案治疗的结肠癌患者两年OS率为75.8%,两年DFS率为72.7%。ECOG 2级体能状态、T4期以及化疗周期较少显著预示OS较差,中低组织学分级显著预示DFS较差。

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