Trends in treatment and survival in older patients presenting with stage IV colorectal cancer.
Trends in treatment and survival in older patients presenting with stage IV colorectal cancer.
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DOI：
10.1007/s11605-013-2406-z
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发表时间：
2014-02
影响因子：
3.2
通讯作者：
Riall, Taylor S.
中科院分区：
文献类型：
--
作者：
Vargas, Gabriela M.;Sheffield, Kristin M.;Parmar, Abhishek D.;Han, Yimei;Gajjar, Aakash;Brown, Kimberly M.;Riall, Taylor S.
尚未评估老年 IV 期结直肠癌患者现代化疗方案的使用趋势、原发肿瘤切除以及化疗和切除的时机。我们使用癌症登记和医疗保险关联数据（2000-2009）来描述≥66 名 IV 期结直肠癌患者（N=16,168）切除原发肿瘤和接受化疗的时间趋势。平均年龄为77.8±7.3岁。 53.8% 为女性，82.9% 为白人。原发癌症部位为结肠（83.4%）和直肠（16.6%）。从2001年到2009年，原发肿瘤的切除率从64.6%下降到57.1%（P<0.0001）。 45.1%的患者接受了全身化疗。虽然化疗的使用随着时间的推移保持稳定（P=0.48），但接受化疗的患者中含有奥沙利铂或伊立替康的现代治疗方案的使用从 40.9% 增加到 75.4%（P<0.0001）。贝伐珠单抗的使用从 0.10% 增加到 54.2% (P<0.0001)。即使在控制治疗和肿瘤位置后，生存率每年仍提高 4%（HR=0.96，95% CI 0.95-0.97）。随着时间的推移，患有 IV 期疾病的老年患者的生存率正在提高。大多数患者仍进行手术切除。切除率下降，而现代化疗迅速采用，这可能表明实践模式发生了转变。
Trends in the use of modern chemotherapeutic regimens, primary tumor resection, and the timing of chemotherapy and resection in older patients with stage IV colorectal cancer have not been evaluated. We used cancer registry and Medicare linked data (2000-2009) to describe time trends in resection of the primary tumor and receipt of chemotherapy in patients ≥66 presenting with stage IV colorectal cancer (N=16,168). The mean age was 77.8±7.3 years. 53.8% were women and 82.9% were white. Primary cancer sites were colon in 83.4% and rectum in 16.6%. Resection of the primary tumor decreased from 64.6% to 57.1% (P<0.0001) from 2001-2009. Systemic chemotherapy was given to 45.1% of patients. While the use of chemotherapy was stable over time (P=0.48), the use of modern regimens containing oxaliplatin or irinotecan increased from 40.9% to 75.4% (P<0.0001) of patients receiving chemotherapy. Bevacizumab use increased from 0.10% to 54.2% (P<0.0001). Survival improved by 4% per year even after controlling for treatment and tumor location (HR=0.96, 95% CI 0.95-0.97). Survival in older patients with stage IV disease is improving over time. Surgical resection is still performed in the majority of patients. Resection rates decreased while modern chemotherapy was rapidly adopted perhaps suggesting a shift in practice patterns.
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影响因子：
50.5
作者：
van Steenbergen, L. N.;Elferink, M. A. G.;Coebergh, J. W. W.
通讯作者：
Coebergh, J. W. W.
影响因子：
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作者：
Basili, Giancarlo;Lorenzetti, Luca;Goletti, Orlando
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45.3
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Kopetz, Scott;Chang, George J.;McWilliams, Robert R.
通讯作者：
McWilliams, Robert R.
影响因子：
158.5
作者：
Hurwitz, H;Fehrenbacher, L;Kabbinavar, F
通讯作者：
Kabbinavar, F
影响因子：
45.3
作者：
Temple, LKF;Hsieh, L;Schrag, D
通讯作者：
Schrag, D