Oncology:治疗延迟是否会对进展期胃癌患者预后造成不良影响

2015-08-28 张森 译 MedSci原创

进展期胃癌(AGC)指癌组织已浸润到粘膜下层,进入肌层或已穿过肌层达浆膜者,此期根据肉眼形态可分为息肉型、溃疡型和浸润型等几种类型,同时浸润型胃癌常使胃壁增厚,变硬而形成皮革胃。临床研究表明,近50%的胃癌患者被诊断为进展期胃癌,而进展期胃癌患者的中位数总生存率(OS)常小于12个月。尽管积极的治疗常能达到一定程度的缓解,但同时也产生了一些不良作用。目前,就早期治疗是否能改善所有进展期胃癌患者的预

进展期胃癌(AGC)指癌组织已浸润到粘膜下层,进入肌层或已穿过肌层达浆膜者,此期根据肉眼形态可分为息肉型、溃疡型和浸润型等几种类型,同时浸润型胃癌常使胃壁增厚、变硬而形成皮革胃。临床研究表明,近50%的胃癌患者被诊断为进展期胃癌,而进展期胃癌患者的中位数总生存率(OS)常小于12个月。尽管积极的治疗常能达到一定程度的缓解,但同时也产生了一些不良作用。目前,就早期治疗是否能改善所有进展期胃癌患者的预后仍没有定论。

德克萨斯大学安德森癌症中心的研究人员,对数据库中有关进展期胃癌研究进行了一项回顾性分析。将患者分为无症状组及症状组。旨在评价系统治疗的延迟是否会对无症状的进展期胃癌患者不利。

共有135例进展期胃癌患者参与了这项研究,大多数患者的特点为:存在临床症状(68%)、男性(67%)、以及低ECOG评分(0-1;85%)。单变量分析显示,ECOG体力状态(P=0.005),初始治疗延迟(P=0.03),缺乏症状(P=0.03)与长期总体生存率相关。总体生存率多变量模型确定只有ECOG体力状态可作为长期总体生存率的独立预测指标。与在4周内接受治疗的患者(总体生存率为58%)相比,系统治疗延迟的无症状患者在1年中的总体生存率为77%(P=0.47)。

本研究表明:伴随临床症状的进展期胃癌患者的预后将更差;然而,无症状进展期胃癌患者系统治疗的延迟并不会对其预后产生不利影响,这也就允许患者可根据自身情况对治疗时间做出选择。

原始出处:

Elimova E, Shiozaki H,et al.Early versus Delayed Therapy of Advanced Gastric Cancer Patients - Does It Make a Difference?Oncology. 2015 Jul 8.

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    2016-07-23 minlingfeng
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