年龄,并发症和多药对接受晚期癌症全身疗法的影响:一项以人口为基础的回顾性研究
Rebekah Rittberg1, Kathleen Decker2, Pascal Lambert3
1Department of Internal Medicine, University of Manitoba, Winnipeg, Canada; Department of Medical Oncology, BC Cancer, Vancouver, Canada.
患有晚期癌症的老年人因年龄,并发症和多药性而接受的系统治疗 (ST) 较少. 年龄与癌症类型和阶段相互作用,但并发症和多药效应在不同年龄段保持不变.
科学领域:
- 老年瘤学 老年瘤学
- 临床瘤学临床瘤学
- 医疗服务研究 医疗服务研究
背景情况:
- 癌症发病率,并发病率和多药性随着年龄的增长而增加.
- 这些因素对晚期癌症的全身疗法 (ST) 的相互作用尚未研究.
研究的目的:
- 调查年龄,并发症和多药与晚期癌症中ST接收的关联.
- 检查这些因素与年龄的相互作用效应.
主要方法:
- 在加拿大马尼托巴省2004-2015年诊断的17228名患有晚期癌症 (多发性骨髓瘤,肺,非霍奇金淋巴瘤,乳腺,结直肠,前列腺,卵巢) 的患者进行了回顾性队列研究.
- 分析了人口统计,癌症特征,治疗,并发症 (查尔森并发症指数,资源利用带) 和多药性 (≥6种药物) 的数据.
- 多变量逻辑回归评估了与ST接收的关联和与年龄的相互作用.
主要成果:
- 50%的患者接受了ST. 增加年龄,多药性和并发症独立降低了ST的可能性.
- 年龄与癌症阶段和类型相互作用;不同阶段的ST概率差异与年龄的增加趋同.
- 多发性骨髓瘤患者的患病率最高,肺癌患者的患病率最低.
结论:
- 年龄,多药性和并发性疾病独立地与晚期癌症中减少ST接收有关.
- 随着年龄的增加,共发病和多药对ST接收的影响并没有有意义地不同.
- 年龄与癌症的阶段和类型有显著的相互作用,影响ST接收模式.
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