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在头癌中延迟诊断到治疗间隔 (DTI) - 系统性审查和元分析

Noémie Villemure-Poliquin¹, Rui Fu¹, Karolina Gaebe²

¹Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada.

|November 22, 2024

概括

在30天内开始治疗头癌,总体生存益处为9%. 然而,数据异质性限制了对其他结果的结论,强调了对诊断治疗间隔进行进一步研究的需要.

科学领域:

在瘤学瘤学.
癌症研究癌症研究
临床结果临床结果

背景情况:

延迟诊断到治疗间隔 (DTI) 对头癌 (HNC) 患者的结果产生负面影响.
多模式HNC治疗可能导致治疗开始的延迟.
了解DTI后果对于改善HNC患者护理至关重要.

研究的目的:

系统地审查延迟DTI对HNC的瘤和生活质量 (QoL) 结果的影响.
在HNC患者治疗中提出DTI的质量基准.

主要方法:

在MEDLINE,Embase,CENTRAL,Web of Science和CINAHL搜索相关的试验和队列研究.
包括评估DTI对整体生存 (OS),无病生存 (DFS),局部区域复发 (LRR),局部复发 (LR) 和远程转移的影响的研究.
对来自63篇文章的数据进行了综合分析,这些文章代表了873718名患者.

主要成果:

在30天内开始治疗与生存状况有9%的改善有关 (aHR: 1.09 [1.06-1.13]).
在30天的DTI和DFS,LRR,LR或远程转移之间没有发现显著的关联.
在聚合分析中观察到显著的异质性 (I2 = 80%).

结论:

30天的DTI可能会改善一些HNC患者的生存率,但显著的数据异质性限制了概括性.
需要进一步的研究,根据治疗方式和癌症阶段进行调整.
文献上的空白和DTI分类中的方法限制需要注意.

关键词:

从诊断到治疗的时间间隔.头癌是头部和部的癌症.质量指标是一种质量指标.状细胞癌瘤是一种状细胞癌.延迟治疗延迟治疗时间

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