中华放射医学与防护杂志

吴健伟,李小凡,李永恒,蔡勇.63例老年胃癌患者的放疗安全性评估[J].中华放射医学与防护杂志,2016,36(11):827-831

63例老年胃癌患者的放疗安全性评估

Safety assessment for radiotherapy combined with chemotherapy or not in 63 elderly patients with gastric cancer

投稿时间：2016-07-20

DOI：10.3760/cma.j.issn.0254-5098.2016.11.006

英文关键词:Gastric cancer Elderly patients Radiotherapy Chemoradiotherapy Toxicity

基金项目:

作者	单位	E-mail
吴健伟	100142 北京, 北京大学肿瘤医院暨北京市肿瘤防治研究所放疗科, 恶性肿瘤发病及转化教育部重点实验室
李小凡	100142 北京, 北京大学肿瘤医院暨北京市肿瘤防治研究所放疗科, 恶性肿瘤发病及转化教育部重点实验室
李永恒	100142 北京, 北京大学肿瘤医院暨北京市肿瘤防治研究所放疗科, 恶性肿瘤发病及转化教育部重点实验室
蔡勇	100142 北京, 北京大学肿瘤医院暨北京市肿瘤防治研究所放疗科, 恶性肿瘤发病及转化教育部重点实验室	caiyong109@sohu.com

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中文摘要:

目的探讨老年胃癌患者放疗的安全性。方法回顾性分析2009年3月-2014年12月63例≥70岁）、接受放疗及放化疗的胃癌患者，均经病理确诊。男性48例，女性15例，中位年龄74（70~85）岁，分期Ⅰ_b~Ⅳ期，中位放疗剂量50（16~60）Gy，中位放疗时间36（11~73）d，同期联合以氟尿嘧啶类为基础的化疗或不联合。观察患者治疗完成情况、不良反应、症状控制、近期疗效及1、2年生存率。比较同期放化疗组和单纯放疗组的生存和治疗耐受情况。结果 63例患者中，81.0%（51/63）的患者按计划完成放疗。19.0%（12/63）的患者出现3、4级不良反应，其中血液毒性占9.5%（6/63），胃肠道反应发生率9.5%（6/63）。56例近期疗效可评价，其中7.1%（4/56）完全缓解（CR），39.3%（22/56）部分缓解（PR），39.3%（22/56）疾病稳定（SD）。中位随访时间13.75个月（1.5~69个月），中位生存时间17个月（95%CI6.9~21.1），1、2年总生存（OS）率分别为55.0%（95%CI 48.6% ~61.4%）及36.2%（95%CI29.2% ~43.2%）。同期放化疗组和单纯放疗组的中位生存时间分别为20.5和12个月，差异无统计学意义（P>0.05）。两组严重不良反应发生情况的差异亦无统计学意义（P>0.05）。结论多数老年胃癌患者能耐受放疗和放化疗，不良反应在允许范围内，并且有一定的疗效。

英文摘要:

Objective To investigate the safety of external beam radiotherapy for elderly patients with gastric cancer. Methods This retrospective study included 63 histologically confirmed gastric cancer patients aged over 70 years(48 males and 15 females), with a median age of 74 (70-85) years, whose American Joint Committee on Cancer Staging(AJCC) Stage ranged from Ⅰ_b to Ⅳ at Beijing Cancer Hospital between March 2009 and December 2014. The median radiation dose was 50(16-60) Gy and the median radiation duration was 36 (11-73) days, concurrently combined with chemotherapy based on fluoropyimidine or not. The completion of radiation, toxicities, evaluations of short-term effect, and 1, 2-year overall survival rates were surveyed and analyzed. Compared the survival and the toxicity in chemoradiotherapy arm and radiotherapy arm. Results Of the total 63 patients, radiotherapy had been completed in 51 patients (81.0%). The incidence of grade 3 or greater acute toxicity as noted was 19.0% of patients (12/63), which included hematologic toxicity 9.5% (6/63) and upper gastrointestinal tract toxicity 9.5% (6/63). The responses to radiotherapy and chemoradiotherapy were evaluated on 56 patients. The complete response (CR) rate was 7.1% (4/56), partial response (PR) rate was 39.3% (22/56), and stable disease (SD) rate was 9.3% (22/56). The duration of follow-up time was 1.5-69 months and median duration was 17 months. The survival time was 6.9-21.1 months and median survival time was 17 months. The 1- and 2-year overall survival rate was 55.0% (95% CI48.6%-61.4%) and 36.2% (95% CI29.2%-43.2%), respectively. There was no significant difference between chemoradiotherapy and radiotherapy arms in terms of survival time (median survival:20.5 months vs.12 months, P>0.05), as well as toxicity (P>0.05). Conclusions The toxicity of radiotherapy and chemoradiotherapy for elderly patients with gastric cancer is acceptable, and the effectiveness of the treatment is satisfactory.

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