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通过综合老年评估评估的适合的老年中晚期直肠癌患者术前放化疗的安全性和有效性:一项多中心II期试验的计划中期分析

Safety and efficacy of preoperative chemoradiotherapy in fit older patients with intermediate or locally advanced rectal cancer evaluated by comprehensive geriatric assessment: A planned interim analysis of a multicenter, phase II trial.

作者信息

Liu Wen-Yang, Jin Jing, Tang Yuan, Li Ning, Tang Yu, Wang Jun, Cheng Yun-Jie, Yang Lin, Fang Hui, Lu Ning-Ning, Qi Shu-Nan, Chen Bo, Wang Shu-Lian, Song Yong-Wen, Liu Yue-Ping, Li Ye-Xiong, Liu Zheng, Zhou Hai-Tao, Liang Jian-Wei, Pei Wei, Wang Xi-Shan, Zhang Hai-Zeng, Zhou Zhi-Xiang

机构信息

Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

J Geriatr Oncol. 2021 May;12(4):572-577. doi: 10.1016/j.jgo.2020.10.016. Epub 2020 Nov 4.

Abstract

BACKGROUND AND PURPOSE

Comprehensive geriatric assessment (CGA) is a diagnostic method to assess the physical and mental health status of older patients. The purpose of this study was to assess the safety and efficacy of preoperative concurrent chemoradiotherapy (preCRT) for intermediate or locally advanced rectal cancer in older people who were classified as "fit" by CGA. The interim analysis focusing on safety was reported here as the first part of this trial.

METHODS AND MATERIALS

This is a single arm, multicenter, phase II trial. The eligible patients for this study were aged 70 years or above that fulfilled the standard of intermediate or locally advanced risk category, and met the standard of fit (SIOG1) evaluated by CGA. All patients received preCRT (50 Gy) with Raltitrexed (3 mg/m on d1 and d22). Qualitative and quantitative variables were described using descriptive statistics. The surgery adherence predicting was analyzed by multivariate logistic regression.

RESULTS

Thirty-nine fit patients were enrolled. All patients except one finished radiotherapy without dose reduction. Thirty-two patients finished the prescribed Raltitrexed therapy as scheduled. A serious toxicity was observed in 12 patients (30.8%), and only six patients (15.4%) experienced non-hematological side effects.

CONCLUSION

Overall, our results showed that preCRT was feasible and safe in older patients with rectal cancer who were evaluated as fit based on CGA, supporting the use of CGA to tailor oncological treatment and predict the tolerance of a specific therapy. Completing this trial as planned would provide further valuable insights.

摘要

背景与目的

综合老年评估(CGA)是一种评估老年患者身心健康状况的诊断方法。本研究的目的是评估术前同步放化疗(preCRT)对经CGA分类为“健康”的老年中晚期直肠癌患者的安全性和有效性。作为本试验的第一部分,本文报告了聚焦安全性的中期分析。

方法与材料

这是一项单臂、多中心、II期试验。本研究的合格患者年龄在70岁及以上,符合中晚期风险类别标准,并达到CGA评估的健康标准(SIOG1)。所有患者接受preCRT(50 Gy)联合雷替曲塞(第1天和第22天3 mg/m)治疗。使用描述性统计描述定性和定量变量。通过多因素逻辑回归分析手术依从性预测因素。

结果

纳入39例健康患者。除1例患者外,所有患者均未减量完成放疗。32例患者按计划完成了规定的雷替曲塞治疗。12例患者(30.8%)观察到严重毒性反应,仅6例患者(15.4%)出现非血液学副作用。

结论

总体而言,我们的结果表明,preCRT对经CGA评估为健康的老年直肠癌患者是可行且安全的,支持使用CGA来定制肿瘤治疗方案并预测特定治疗的耐受性。按计划完成本试验将提供进一步有价值的见解。

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