胰腺腺癌与血管参与的新辅助化疗中的差异
Nikhil Chervu1, Shineui Kim1, Sara Sakowitz1
1Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Surgery open science
|July 18, 2024
概括
胰腺癌的新辅助化疗 (NAT) 改善了生存率,但存在差异. 这项研究发现,NAT使用量增加,但黑人患者,医疗保险/医疗补助计划的患者和非学术中心的患者的几率较低.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 多剂新辅助化疗 (NAT) 与局部晚期 (LA) 或边缘切除性 (BR) 胰腺管道腺癌 (PDAC) 的生存率有所改善.
- 对于PDAC的NAT的利用模式和潜在差异仍然不完全理解.
研究的目的:
- 为了评估BR/LA PDAC的NAT利用的时间趋势.
- 评估NAT与生存结果的关联.
- 确定与NAT接收相关的患者和机构因素,并调查潜在的差异.
主要方法:
- 来自2011-2017年全国癌症数据库的成年PDAC患者的分析.
- 使用临床T阶段和CS_EXTENSION变量评估的瘤血管参与.
- 统计分析包括Cuzick的非参数测试趋势,Cox的比例危险模型死亡率,以及NAT接收因子的后勤回归.
主要成果:
- 在3811名患者中,50.8%接受了NAT,利用率从2011年的31.7%增加到2017年的81.1% (p < 0.001).
- NAT与显著降低两年死亡率 (HR 0.34,95% CI [0.18-0.67]) 有关.
- 与减少NAT几率相关的因素包括黑人种族,医疗保险/医疗补助保险,非学术机构的治疗和较低的教育水平.
结论:
- 对BR/LA胰腺腺癌的NAT利用量显著增加.
- 尽管与NAT相关的生存率有所改善,但在使用中仍然存在显著的社会经济和种族差异.
- 解决这些差异至关重要,以确保PDAC患者平等获得可能挽救生命的治疗.
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