老年恶性肿瘤患者化疗中止原因

发布时间：2018-04-20 15:35

本文选题：恶性肿瘤 + 化疗　；参考：《中国老年学杂志》2017年24期

【摘要】：目的分析导致住院老年恶性肿瘤患者化疗中止的原因,并探讨防止化疗中止的对策。方法回顾性分析该院2013年1月至2015年4月老年医学科住院的老年恶性肿瘤患者94例,平均(83±4)岁。其中化疗中止组48例,分析导致化疗过程中某一次或多次化疗中止的原因,完成按期化疗的按期化疗组46例,比较两组化疗前慢性疾病、血液相关指标、微型营养评估(MNA)、功能独立性(FIM)及卡氏功能状态评分(KPS)等情况。结果与按期化疗组相比,中止化疗组前白蛋白、白蛋白、低密度脂蛋白胆固醇水平、MNA评分及KPS评分均明显降低(P0.05)。Logistic回归分析显示,导致化疗中止的因素有高龄、营养不良、合并慢性阻塞性肺疾病(COPD)及糖尿病。对患者进行年龄分层,≥80岁的肿瘤患者化疗后发生骨髓抑制及感染的风险明显增加(P0.05)。结论化疗前对老年恶性肿瘤患者进行营养等综合评估,选择合适的化疗方式,能使患者化疗间歇期被动性延长的风险降低,有利于患者按期化疗。MNA评分低于23.5分及80岁及以上的老年恶性肿瘤患者被迫中止化疗的风险高。
[Abstract]:Objective to analyze the causes of the termination of chemotherapy in elderly patients with malignant tumor, and to explore the countermeasures to prevent the termination of chemotherapy. Methods from January 2013 to April 2015, 94 inpatients with malignant tumors in geriatrics department in our hospital were retrospectively analyzed, with an average age of 83 卤4 years. Among them, 48 cases in the chemotherapy suspension group, the cause of one or more chemotherapy suspension in the course of chemotherapy was analyzed, 46 cases of the scheduled chemotherapy group completed the scheduled chemotherapy, the two groups were compared with the two groups of chronic diseases before chemotherapy, blood related indexes. MNAA, FIMM and KPSs. Results compared with the scheduled chemotherapy group, the prealbumin, albumin, low density lipoprotein cholesterol (LDL-C) scores and KPS scores in the aborted chemotherapy group were significantly lower than those in the scheduled chemotherapy group. Logistic regression analysis showed that the factors leading to the termination of chemotherapy were old age and malnutrition. Chronic obstructive pulmonary disease (COPD) and diabetes mellitus. The risk of bone marrow suppression and infection in cancer patients aged over 80 years after chemotherapy was significantly increased by age stratification (P 0.05). Conclusion the risk of prolonging the duration of chemotherapy interval can be reduced by comprehensive evaluation of nutrition and selection of appropriate chemotherapy methods in elderly patients with malignant tumor before chemotherapy. Patients with malignant tumors aged 80 years and over were at a high risk of being forced to suspend chemotherapy in accordance with their scheduled chemotherapy .MNA scores were less than 23.5 points.
【作者单位】：安徽省立医院老年医学科干五病区;
【分类号】：R730.53

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