146例胃癌骨转移患者特征及预后因子的单中心分析

发布时间：2018-06-05 18:06

本文选题：胃癌 + 骨转移　；参考：《中国肿瘤临床》2017年12期

【摘要】：目的:研究胃癌骨转移患者的临床特征、治疗模式及预后因子。方法:收集1996年12月至2014年12月北京肿瘤医院收治的146例胃癌骨转移患者临床资料,进行单因素和多因素生存分析。结果:所有患者中,51例(34.9%)为同时性骨转移,95例为(65.1%)异时性骨转移。35例(24.0%)患者以骨转移为唯一远处转移灶;111例(76.0%)合并其他部位转移,包括肝(30.0%)、腹膜(24.0%)、肺(15.1%)和骨髓(7.5%)。发生骨转移后,99例(67.8%)患者接受双膦酸盐治疗,34例(23.3%)行骨放疗,5例(3.4%)行骨手术;此外,96例(65.6%)患者接受全身化疗。骨转移后患者的中位生存时间(median overall survival,mOS)为5.8个月(95%CI:4.284~7.316)。多因素分析显示KPS80分(P=0.030)、存在骨髓转移(P0.001)、骨转移后未全身化疗(P0.001)、糖类抗原199(carbohydrate antigen 199,CA199)升高(P0.001)是独立的不良预后因子。结论:胃癌骨转移患者预后差,生存期短,尤其是合并骨髓转移、KPS评分较差及CA199升高者,发生骨转移后给予全身化疗可能给患者带来生存获益。
[Abstract]:Objective: to study the clinical features, treatment patterns and prognostic factors of patients with bone metastasis of gastric cancer. Methods: the clinical data of 146 patients with bone metastasis from December 1996 to December 2014 were collected and analyzed by univariate and multivariate analysis. Results: among all the patients, 51 cases (34.9) were synchronic bone metastases, 95 cases were synchronic bone metastases. (35 cases had histopathological bone metastases.) among them, bone metastasis was the only distant metastasis in 111 cases (76.0) and other metastatic sites, including liver metastasis 30.0%, peritoneum 24.0, lung cavity 15.1) and bone marrow 7.5T. After bone metastasis, 99 patients (67.8%) received bisphosphonate therapy (23.3 cases) bone radiotherapy was performed in 5 cases (3.4%) and 96 cases (65.6%) received systemic chemotherapy. The median survival time (median overall survival) of patients with bone metastasis was 5.8 months and 95% CI: 4.284 / 7.316%. Multivariate analysis showed that the presence of bone marrow metastasis (P0.001), the absence of systemic chemotherapy after bone metastasis (P0.001), and the elevation of carbohydrate antigen (199(carbohydrate antigen 1999 / CA1999) were independent prognostic factors. Conclusion: the prognosis of patients with bone metastasis of gastric cancer is poor, the survival time is short, especially the patients with bone marrow metastasis and CA199 increase, the patients may benefit from systemic chemotherapy after bone metastasis.
【作者单位】：北京大学肿瘤医院暨北京市肿瘤防治研究所消化肿瘤内科恶性肿瘤发病机制及转化研究教育部重点实验室;
【分类号】：R735.2

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