摘要
目的探讨食管鳞癌(esophageal squamous cell carcinoma,ESCC)术后化疗方案与预后生存及副作用的关系。方法收集2014年6月―2018年11月18日于福建医科大学附属第一医院、福建省肿瘤医院就诊的ESCC患者病例,根据明确的纳入和排除标准,最终纳入188例。使用Kaplan-Meier法计算累计生存概率,log-rank进行组间差异比较,Cox回归分析生存影响因素,应用多组独立样本秩和检验比较化疗方案组间的副作用,采用非条件Logistic回归分析模型分析化疗方案与ESCC术后副作用的相关性。结果化疗方案是ESCC预后的影响因素,其中"多西他赛(docetaxel,DOC)+洛铂(luoplatinum,LBP)/奥沙利铂(oxaliplatin,OXA)"、"紫杉醇(paclitaxel,PTX)+LBP/OXA"化疗方案总生存期均优于"DOC+顺铂(cisplatin,DDP)/奈达铂(nedaplatin,NDP)"组化疗方案;化疗方案与ESCC术后出现的血液/骨髓异常等副作用相关(χ~2=11.741,P=0.008),"DOC+LBP/OXA"组较"DOC+DDP/NDP"组化疗方案,会增加白细胞降低发生的风险(OR=4.089,95%CI:1.073~15.585,P=0.039),减少淋巴细胞水平降低发生的风险(OR=0.257,95%CI:0.075~0.878,P=0.030)。结论化疗方案是ESCC术后预后生存及副作用的影响因素,"DOC+LBP/OXA"、"PTX+LBP/OXA"两组化疗方案的预后生存情况优于"DOC+DDP/NDP"化疗方案;"DOC+LBP/OXA"化疗方案相对其它方案可降低副作用的发生风险。
Objective To investigate the relationship between post-operative chemotherapy, prognosis and side-effects of esophageal squamous cell carcinoma(ESCC). Methods This study enrolled a total of 188 patients with ESCC in the First Affiliated Hospital of Fujian Medical University and Fujian Cancer Hospital from June 2014 to November 18 th 2018. The cumulative survival rates were estimated using the Kaplan-Meier method and comparisons were performed using the log-rank test. The Cox proportional hazards model was performed for analysis of the impact factors of survival and the Kruskal-Wallis H test was used to compare side-effects of chemotherapy regimens. The unconditional Logistic regression was performed to analyze the correlation between postoperative chemotherapy regimens and side-effects. Results The chemotherapy regimen was an independent risk factor for poor survival of ESCC patients. Compared with "docetaxel(DOC)+cisplatin(DDP)/nedaplatin(NDP)" group, ESCC patients in "paclitaxel(PTX)+luoplatinum(LBP)/oxaliplatin(OXA) " group and "DOC +LBP/OXA" group had better overall survival. The post-operative chemotherapy regimen was related to blood/bone marrow abnormalities and other side-effects(χ~2=11.741, P=0.008). Compared with "DOC+DDP/NDP" group, "DOC+LBP/OXA" group increased the risk of leukocyte reduction(OR=4.089, 95% CI:1.073~15.585, P=0.039) and decreased the risk of lymphocyte reduction(OR=0.257, 95% CI:0.075~0.878, P=0.030). Conclusions The chemotherapy regimen is the impact factor for the prognosis and side-effects of patients with ESCC. The prognosis of "DOC+LBP/OXA" group and "PTX+LBP/OXA" group is better than "DOC+DDP/NDP" group. The "DOC+LBP/OXA" group reduces the risk of side-effects.
作者
李姗姗
林征
马明阳
苏昆卉
陈雅婷
刘永兰
胡志坚
LI Shan-shan;LIN Zheng;MA Ming-yang;SU Kun-hui;CHEN Ya-ting;LIU Yong-lan;HU Zhi-jian(Department of Epidemiology and Health Statistics,School of Public Health,Fujian Medical University,Fuzhou 350122,China)
出处
《中华疾病控制杂志》
CAS
CSCD
北大核心
2020年第7期808-813,共6页
Chinese Journal of Disease Control & Prevention
基金
福建医科大学公共卫生学院大学生科研创新项目(201902)
国家重点研发计划精准医学研究重点专项2017年度项目(2017YFC0907100)
2018年福建省医学创新课题(2018-CX-38)
福建医科大学启航基金(2018QH2012)。
关键词
食管鳞癌
化疗
生存分析
副作用
Esophageal squamous cell carcinoma
Chemotherapy regimen
Survival analysis
Side Effects
