PO.ET02.07 · 实验与分子治疗
韩国结直肠癌患者抗癌药物使用情况分析
Anti-cancer drug usage analysis among Korean patients with colorectal cancer
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
联合化疗长期以来一直是结直肠癌治疗的核心，而治疗模式也随着新出现的临床证据、指南变化以及特定药物的可及或撤市而不断演变。本研究旨在通过对韩国国家癌症中心（NCC）治疗的韩国结直肠癌患者抗癌药物使用的时间变化进行描述性分析，来表征用药随时间的变化。研究考察了两个患者队列：2000-2004 年间接受治疗的患者和 2010-2020 年间接受治疗的患者。纳入了在两个队列中均给予 ≥10 名患者使用的 16 种抗癌药物。使用 Stata/BE 18.0 对 2000-2004 年队列的 1,188 名患者和 2010-2020 年队列的 1,043 名患者进行分析。在 2000-2004 年队列中，单药治疗是最主要的治疗方式（55.89%），其次是两药联合治疗（17.68%）。在单药治疗中，5-氟尿嘧啶（5-FU）使用最为频繁（45.96%）。这一时期最常见的两药方案是卡培他滨加 5-FU（4.88%）。到 2010-2020 年，治疗模式发生转变，两药联合化疗变得比单药治疗更为常见（38.73% 对 32.02%）。5-FU 加奥沙利铂联合方案成为使用最频繁的方案（25.98%）。卡培他滨是最常见的单药方案（21%）。尽管与 2000-2004 年相比，2010-2020 年卡培他滨单药的使用有所增加（21% 对 5.56%），但卡培他滨总体使用的差异无统计学意义（p = 0.872），这可能是因为卡培他滨在早年常被用于联合方案。相比之下，5-FU 的使用显著下降（p < 0.001），而奥沙利铂和贝伐珠单抗的使用显著增加（均 p < 0.001）。同时，替加氟/尿嘧啶和甲地孕酮的使用显著减少（均 p < 0.001）。这项描述性分析突显了韩国 NCC 治疗的结直肠癌患者在两个不同时期化疗使用的转变。较早的队列（2000-2004）以 5-FU 为基础的单药治疗为主，而较晚的队列（2010-2020）则显示出明显向两药联合的转变。这些模式反映了全球抗癌治疗药物使用的变化。进一步的分析应将治疗模式与临床结局相关联，包括对总生存期（OS）和无病生存期（DFS）的评估、治疗线数的厘清，以及重叠处方或方案编码问题的解决。本研究已获得 NCC 机构审查委员会批准（NCC2025-0115）。
查看英文原文 English abstract
Combination chemotherapy has long been central to the management of colorectal cancer, and treatment patterns have evolved in response to emerging clinical evidence, changing guidelines, and the availability or withdrawal of specific agents. This study aims to characterize changes in medication utilization over time by providing a descriptive analysis of temporal changes in anticancer drug use among Korean colorectal cancer patients treated at the National Cancer Center (NCC) of Korea. Two patient cohorts were examined: individuals treated between 2000-2004 and those treated between 2010-2020. Sixteen anticancer agents administered to ≥10 patients in both cohorts were included. A total of 1,188 patients from the 2000-2004 cohort and 1,043 patients from the 2010-2020 cohort were analyzed using Stata/BE 18.0. In the 2000-2004 cohort, monotherapy was the most predominant treatment approach (55.89%), followed by two-drug combination therapy (17.68%). Among monotherapies, 5-fluorouracil (5-FU) was most frequently used (45.96%). The most common two-drug regimen during this period was capecitabine plus 5-FU (4.88%). By 2010-2020, treatment patterns shifted as two-drug combination chemotherapy became more common than monotherapy (38.73% vs. 32.02%). The 5-FU plus oxaliplatin combination emerged as the most frequently used regimen (25.98%). Capecitabine was the most common regimen for monotherapy (21%). Although the use of capecitabine monotherapy increased in 2010-2020 compared to 2000-2004 (21% vs. 5.56%), the difference in overall capecitabine usage was not statistically significant (p = 0.872), likely because capecitabine had frequently been used in combination regimens in earlier years. In contrast, use of 5-FU significantly declined (p < 0.001), while use of oxaliplatin and bevacizumab markedly increased (both p < 0.001). Meanwhile, tegafur/uracil and megestrol usage decreased significantly (both p < 0.001). This descriptive analysis highlights shifts in chemotherapy use among colorectal cancer patients treated at the NCC of Korea across two distinct periods. The earlier cohort (2000-2004) was characterized by predominant use of 5-FU-based monotherapy, whereas the later cohort (2010-2020) showed a marked transition toward two-drug combinations. These patterns mirror global changes in anticancer therapy drug usage. Further analyses should link treatment patterns to clinical outcomes, including evaluations of overall survival (OS) and disease-free survival (DFS), clarification of treatment lines, and resolution of overlapping-prescription or regimen-coding issues. This study was approved by the Institutional Review Board of the NCC (NCC2025-0115).
利益披露 Disclosure
Y. Lim, None..
J. Kim, None.