在乳腺癌诊断后,扩大内分泌治疗的使用和决策
Allison W Kurian1, Allison K C Furgal2, Archana Radhakrishnan3
1Departments of Medicine and Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA.
Journal of the National Cancer Institute
|March 31, 2025
概括
近40%的第一阶段和三分之二的第二阶段乳腺癌患者延长了内分泌治疗. 患者的价值观,而不是人口统计数据,影响了在五年后继续治疗的决定.
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:
- 辅助内分泌疗法是第二阶段乳腺癌的标准,但在第一阶段,其延长超过五年是不太确定的.
- 了解患者对延长内分泌治疗的决策对于优化治疗坚持和结果至关重要.
研究的目的:
- 调查乳腺癌I和II期妇女扩展辅助内分泌治疗的利用和决策过程.
- 确定影响持续内分泌治疗超过5年的决定的因素.
主要方法:
- 在2014-15年间,对2,361名被诊断为I-II期乳腺癌的女性 (20-79岁) 进行了一项调查,其应答率为60%.
- 患有雌激素受体 (ER) 和/或孕激素受体 (PR) 阳性疾病的参与者在诊断后七个月和六年被调查,以了解他们的内分泌治疗延续决定.
主要成果:
- 在决定继续治疗的557名女性中,46.9%的人进行了延长治疗 (39.4%的第一阶段,62.4%的第二阶段).
- 对于I阶段,关键的持续因素包括担心复发 (aOR 3.35),对广泛治疗的愿望 (aOR 2.15) 和初级保健医生的参与 (aOR 4.30).
- 治疗副作用与延续相反相关 (I阶段aOR 0.21). 决策不受种族,种族或人口统计的影响.
结论:
- 近40%的第一阶段和三分之二的第二阶段乳腺癌患者选择延长内分泌治疗.
- 患者的价值观,如复发问题和治疗偏好,显著影响了继续治疗的决定.
- 这些发现可以指导医生与患者在延长内分泌治疗方面的讨论,并根据个体患者的情况量身定制建议.
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