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目的 探讨老年结直肠癌患者术后化疗依从性及其影响因素.方法 回顾行分析2000年1月至2010年1月间中山大学肿瘤防治中心收治的386例年龄70岁以上的Ⅱ～Ⅳ期结直肠癌患者的临床病理资料,其中226例接受术后化疗,160例(41.4％)拒绝化疗.通过Logistic回归模型分析影响术后化疗依从性的客观因素.通过电话随访了解拒绝或未能完成术后化疗患者的主观原因.结果 多因素分析显示,性别、体质量指数、体表面积、年龄及并发症是老年结直肠癌患者术后化疗依从性的独立影响因素(均P＜0.05).电话随访结果显示,80例未行术后化疗的Ⅱ期结直肠癌患者中,有51例(63.8％)是因为医生的建议程度不够.Ⅲ期患者中,对化疗的恐惧(31.2％,15/48)、自我感觉体质差(18.8％,9/48)及经济困难(18.8％,9/48)是阻碍化疗的主要因素;Ⅳ期患者对不良预后的绝望是放弃化疗的主要原因(56.2％,18/32).结论 患者的性别、体表面积、年龄及术后并发症是影响老年结直肠癌术后化疗依从性的客观指标.对于Ⅱ期患者,医生对化疗的建议程度应该加强；对于Ⅲ期患者,仍应采取积极的态度指导其治疗.

Objective To investigate the compliance and associated factors of postoperative chemotherapy for elderly patients with colorectal cancer.Methods A total of 386 elderly patients (＞70 years old) with stage Ⅱ-Ⅳ colorectal cancer underwent surgery between January 2000 and January 2010.The clinicopathological data were retrospectively reviewed.There were 226 patients received postoperative chemotherapy and 160 (41.4％) refused.Logistic regression model was used to analyze factors associated with patients compliance to chemotherapy.Patients were followed up by phone call regarding the reason for refusal.Results Multivariate analysis showed that gender,body mass index (BMI),body surface area (BSA),age,and complication were independent risk factors associated with chemotherapy compliance (All P＜0.05).Follow-up phone questionnaire showed that 63.8％ (51/80) of patients with stage Ⅱ cancer did not received chemotherapy because of the doctor's uncertainty of chemotherapy benefit.For stage Ⅲ patients, fear of chemotherapy (31.2％, 15/48), feeling uncomfortable (18.8％,9/48),and financial issues (18.8％,9/48) were the main factors.The desperate feeling was the predominant reason for stage Ⅳ patients (56.2％, 18/32).Conclusions Gender,BSA,age,and postoperative complication are the main factors associated with compliance to postoperative chemotherapy.Doctors' recommendation should be emphasized for stage Ⅱ patients.For stage Ⅲ patients,treatment recommendation should be enthusiastic.