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目的:分析晚期大肠癌的病理和治疗方法等因素对其生存的影响。方法:采用多因素回归分析方法分析了92例结直肠腺癌患者的生存因素。结果:大肠腺癌中不同的类型生存有差别,但没有达到统计学上的显著性差异;以L-OHP-CPT-11和CPT-11-L-OHP序贯治疗两组患者比较,中位生存时间分别为20·7月和22·8月,两组之间的差别无统计学的显著意义(P>0·05)。多药治疗方案与L-OHP或CPT-11单药以及5-FU/LV治疗三组患者的中位生存时间分别为23·1个月、16·1个月和12·8个月。其中多药治疗方案和仅用5-FU/LV治疗两组患者间的差异有显著性(Logrank检验,P=0·02)。复发或转移后接受综合治疗(包括手术、放疗及介入治疗)的有36例,与单用化疗的66例患者的中位生存期分别为21·8个月及16·8个月,两组患者之间的差异有显著性(Logrank检验,P=0·016)。回归分析还发现,转移器官数目是影响预后的独立因素(P=0·02)。结论:不同的治疗方案影响了晚期大肠癌的生存时间,多学科综合治疗尤其重要,而复发后所累及器官数目则是独立的预后影响因素。
Objective: To analyze the influence of the pathology and treatment of advanced colorectal cancer and other factors on its survival. Methods: Survival factors of 92 patients with colorectal adenocarcinoma were analyzed by multivariate regression analysis. RESULTS: There was a difference in the survival of different types of colorectal adenocarcinomas, but no statistically significant difference was found. Compared with sequential treatment with L-OHP-CPT-11 and CPT-11-L-OHP, the median The survival time was 20.7 months and 22.8 months respectively. There was no significant difference between the two groups (P> 0.05). The median survival time of multi-drug treatment and L-OHP or CPT-11 monotherapy and 5-FU / LV treatment group were 23.1 months, 16.1 months and 12.8 months respectively. Among them, there was significant difference between the multi-drug treatment and 5-FU / LV treatment alone (Logrank test, P = 0.02). The median survival of 36 patients receiving combined treatment (including surgery, radiotherapy and intervention) after relapse or metastasis compared with 66 patients receiving chemotherapy alone was 21.8 months and 16.8 months, respectively. The two groups The difference between patients was significant (Logrank test, P = 0.016). Regression analysis also found that the number of metastatic organs is an independent factor affecting the prognosis (P = 0.02). Conclusion: Different treatment options affect the survival time of advanced colorectal cancer. Multidisciplinary comprehensive treatment is particularly important. However, the number of organs involved in recurrence is an independent prognostic factor.