Comparative effectiveness of adjuvant chemoradiotherapy after gastrectomy among older patients with gastric adenocarcinoma: a SEER-Medicare study.
Comparative effectiveness of adjuvant chemoradiotherapy after gastrectomy among older patients with gastric adenocarcinoma: a SEER-Medicare study.
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DOI：
10.1007/s10120-017-0693-x
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发表时间：
2017-09
期刊：
影响因子：
--
通讯作者：
Schrag D
中科院分区：
文献类型：
--
作者：
Yeh JM;Tramontano AC;Hur C;Schrag D
由于INT-0116试验报告了生存优势，术后放化疗（CRT）已成为美国胃腺癌诊断患者的护理标准。我们试图估计老年美国医疗保险人群中治疗与生存之间的关系。在监测、流行病学和最终结果区域对2002年至2009年间诊断为IB-III期胃腺癌的65-79岁医疗保险受益人进行回顾性队列研究。根据治疗方法对患者进行分类：1)单纯胃切除术，2)胃切除术加辅助CRT。我们检查了与辅助CRT接受相关的因素，包括诊断阶段、合并症和肿瘤亚型。总生存率从胃切除术后90天开始测量，直到死亡或2010年12月31日。在1519例接受胃切除术的患者中，41.7%接受了辅助CRT。与辅助CRT相关的因素包括癌症诊断时年龄<75岁和II期或III期诊断。单纯胃切除术的中位总生存期为25.1个月（四分位间距（IQR）， 43.7个月），辅助CRT的中位总生存期为26.9个月（IQR， 40.9个月）。多变量和倾向评分分层模型显示，与辅助CRT相关的生存获益(HR = 0.58 (95%CI, 0.50 - 0.67)，尽管II期肿瘤（HR = 0.50; 95%CI, 0.39-0.61）和III期肿瘤（HR = 0.58; 95%CI, 0.45-0.73）比IB期肿瘤（HR = 1.02; 95%CI, 0.71-1.45）的幅度更大。与胃切除术相结合的辅助CRT与诊断为II期和III期肿瘤的老年患者的生存获益相关。
Since the INT-0116 trial reported a survival advantage, post-operative chemoradiotherapy (CRT) has been a care standard for US patients diagnosed with gastric adenocarcinoma. We sought to estimate the association between treatment and survival among the older U.S. Medicare population. Retrospective cohort study of Medicare beneficiaries aged 65–79 with stage IB-III gastric adenocarcinoma diagnosed between 2002 and 2009 in a Surveillance, Epidemiology, and End Results region. Patients were categorized based on treatment: 1) gastrectomy only, and 2) gastrectomy plus adjuvant CRT. We examined factors associated with adjuvant CRT receipt, including diagnosis stage, comorbidity, and tumor subtype. Overall survival was measured from 90 days post-gastrectomy until death or the censoring date of December 31, 2010. Of the 1519 patients who underwent gastrectomy, 41.7% received adjuvant CRT. Factors associated with adjuvant CRT included age <75 years of age at cancer diagnosis and stage II or III diagnosis. The median overall survival from time of gastrectomy was 25.1 months (interquartile range (IQR), 43.7 months) for gastrectomy only and 26.9 months (IQR, 40.9 months) for adjuvant CRT. Multivariable and propensity score-stratified models demonstrated a survival benefit associated with adjuvant CRT (HR = 0.58 (95%CI, 0.50–0.67), although the magnitude was greater for stage II (HR = 0.50; 95% CI, 0.39–0.61) and III (HR = 0.58; 95% CI, 0.45–0.73) tumors than stage IB (HR = 1.02; 95%CI, 0.71–1.45). Adjuvant CRT, in conjunction with gastrectomy, was associated with a survival benefit among older patients diagnosed with stage II and III tumors.
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影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
DOI：
10.1111/apm.1965.64.1.31
发表时间：
1965-01-01
期刊：
ACTA PATHOLOGICA ET MICROBIOLOGICA SCANDINAVICA
影响因子：
--
作者：
LAUREN, P
通讯作者：
LAUREN, P
影响因子：
7.2
作者：
Klabunde, CN;Potosky, AL;Warren, JL
通讯作者：
Warren, JL
影响因子：
45.3
作者：
Dikken, Johan L.;Jansen, Edwin P. M.;Verheij, Marcel
通讯作者：
Verheij, Marcel
影响因子：
3.7
作者：
Coburn, Natalie G.;Govindarajan, Anand;Baxter, Nancy N.
通讯作者：
Baxter, Nancy N.