摘要
目的对伴远处转移胰腺癌化疗禁忌证的预测因子进行研究。方法回顾性分析87例序贯入组伴远处转移胰腺癌患者应用5-Fu,顺铂,吉西他滨等化疗后的预后。结果全组中位生存时间为3.8月;3,6,12月的生存率分别为58%,26%和3%。单变量分析显示年龄≥65岁、腹水、总胆红素>2.5mg/dl、血清胆碱酯酶(ChE)<110IU/L、高肿瘤标志物(CA19-9)水平及行为状况评分<80为伴远处转移胰腺癌化疗禁忌症的预测因子。Cox累计风险比例模型分析显示独立化疗禁忌证的预测因子为腹水、ChE水平及年龄。基于上述独立预测因子拟合出化疗风险预测模型为相对死亡风险(RRD)=exp(腹水×1.213+血清胆碱酯酶水平(ChE)×1.065+年龄×0.651)。结论出现腹水、血清胆碱酯酶(ChE)<110IU/L及年龄≥65岁的伴远处转移胰腺癌患者接受化疗并不能延长生存改善预后。
Objective： To investigate predictors of systemic chemotherapy contraindication in pancreatic cancer patients with distant metastasis. Methods： Eighty -seven consecutive pancreatic cancer patients with distant metastasis receiving systemic chemotherapy using 5 - fluorouracil, cisplatin or gemcitabine were analyzed retrospectively to investigate prognostic factors. Results： The overall median survival time of all patients in the whole series was 3.8 months, the 3,6, and 12 months survival rates were 58% , 26% , and 3% , respectively. Significant poor prognostic factors were the age of 65 years old or older, presence of ascite, a total bilirubin 〉 2.5 mg/dl, ChE 〈 110IU/L, a higher level of tumor maker （ CA19 -9） and performance status 〈80 （P 〈0. 005）. Cox proportional hazards model showed that independent poor prognostic factors were presence of ascites, serum ChE level 〈 110IU/L, and age ≥ 65. A prognostic index was calculated based on the regression coefficients derived from the three variables according to their relative risk of death （RRD） = exp （presence of ascites × 1. 213 ＋ serum ChE level × 1. 065 ＋ age ≥ 65 ×0.651 ）. Conclusion： Ascites, ChE 〈 110IU/L, and age ≥65 should be chemotherapy contraindications for pancreatic cancer patients with distant metastasis because of their extremely short survival time.
出处
《现代肿瘤医学》
CAS
2007年第3期377-381,共5页
Journal of Modern Oncology
关键词
胰腺癌
化疗
禁忌证
pancreatic cancer
chemotherapy
contraindication
