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促进了医学肿瘤学家完成病理分期 II 或 III 期胃癌的 1 年辅助 S-1 单药治疗。

Facilitated completion of 1-year adjuvant S-1 monotherapy for pathological stage II or III gastric cancer by medical oncologists.

机构信息

Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.

Department of Upper Gastrointestinal Surgery, Kitasato University School of Medicine, Kanagawa, Japan.

出版信息

Surg Today. 2020 Oct;50(10):1197-1205. doi: 10.1007/s00595-020-01995-8. Epub 2020 Apr 2.

Abstract

PURPOSE

Several factors are known to be significantly associated with a low completion rate of 1-year adjuvant S-1 monotherapy for gastric cancer. The present study investigated whether or not the specialties of physicians conducting adjuvant S-1 monotherapy affect the completion rate.

METHODS

A total of 437 patients who underwent curative gastrectomy followed by adjuvant S-1 monotherapy for pathological stage II or III gastric cancer between 2008 and 2013 were retrospectively analyzed. Factors affecting completion of adjuvant S-1 monotherapy, including the physicians (medical oncologists or surgeons) administering S-1, were evaluated by a multivariate analysis. The relationship between patient factors and physicians was analyzed regarding the cumulative incidence of discontinuation. The number of times the dose was reduced, the schedule changed, or administration was suspended or delayed in patients completing adjuvant S-1 monotherapy was also counted.

RESULTS

The multivariate analysis showed that old age (≥ 65 years old), excess body weight loss (≥ 15%), and surgeons were independently associated with discontinuation. In older patients, the cumulative incidence of discontinuation by medical oncologists was significantly lower than that by surgeons. Medical oncologists ensured that older patients continued S-1 by frequent suspension or a delay in each course.

CONCLUSIONS

Medical oncologists may facilitate completion of adjuvant S-1 monotherapy.

摘要

目的

已知有几个因素与胃癌患者接受 1 年辅助 S-1 单药治疗的低完成率显著相关。本研究调查了进行辅助 S-1 单药治疗的医生的专业是否会影响完成率。

方法

回顾性分析了 2008 年至 2013 年间接受根治性胃切除术并接受辅助 S-1 单药治疗的病理分期 II 或 III 期胃癌的 437 例患者。通过多变量分析评估了影响辅助 S-1 单药治疗完成的因素,包括给予 S-1 的医生(肿瘤内科医生或外科医生)。分析了患者因素与医生之间的关系,以评估停药的累积发生率。还计算了完成辅助 S-1 单药治疗的患者中减少剂量、改变方案、暂停或延迟给药的次数。

结果

多变量分析显示,年龄较大(≥65 岁)、体重过度减轻(≥15%)和外科医生与停药独立相关。在老年患者中,肿瘤内科医生的停药累积发生率明显低于外科医生。肿瘤内科医生通过频繁暂停或延迟每个疗程来确保老年患者继续使用 S-1。

结论

肿瘤内科医生可能有助于完成辅助 S-1 单药治疗。

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