与绝经前乳腺癌患者内分泌疗法坚持模式相关的临床因素
Kirsten M Woolpert1, Julie A Schmidt2, Thomas P Ahern3
1Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark. kwoolpert@clin.au.dk.
对激素受体阳性乳腺癌患者来说,坚持辅助内分泌疗法 (AET) 是非常重要的. 某些患者群体,包括患有早期疾病或并发症的患者,表现出较低的AET坚持,可能增加复发风险.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 辅助内分泌疗法 (AET) 是激素受体阳性乳腺癌的标准.
- 对AET的低于最佳的坚持是一个重大的临床挑战.
- 了解影响AET遵守的因素对于改善患者的治疗结果至关重要.
研究的目的:
- 在绝经前乳腺癌患者中调查AET坚持的纵向趋势.
- 确定与AET坚持模式相关的临床特征.
- 为改善风险人群遵守规则的策略提供信息.
主要方法:
- 基于AET坚持模式的基于组的轨迹建模.
- 从2002-2011年诊断的4353名绝经前乳腺癌患者 (I-III阶段) 的数据分析.
- 多项逻辑回归用于识别坚持模式的预测因素.
主要成果:
- 确定了三个坚持模式:高度坚持 (57%),缓慢下降 (36%) 和快速下降 (6.9%).
- 第一个阶段的疾病,没有化疗,常见的并发病 (CCI≥1) 和慢性非癌症药物使用与快速AET下降的可能性更高有关.
- 几率比率 (ORs) 表示显著的关联 (例如,没有化疗OR:4.3,95%CI 3.0,6.1).
结论:
- 绝经前妇女患有I阶段乳腺癌,没有化疗,更高的并发症负担,以及以前的慢性药物使用,不太可能坚持AET.
- 针对这些群体的有针对性的干预措施可能会改善坚持.
- 加强AET的坚持可能会降低乳腺癌复发风险.
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