障碍物和及时的手术后辐射治疗在头癌中的障碍
Megan T Nguyen1, Emily Kistner-Griffin2,3, Reid DeMass2,3
1Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston.
JAMA otolaryngology-- head & neck surgery
|September 11, 2025
概括
术后放射治疗 (PORT) 的障碍显著延迟了头癌患者的治疗. 护理协调不良是延迟的最常见原因,影响了患者的治疗结果.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 及时的术后放射治疗 (PORT) 对于头部和部状细胞癌 (HNSCC) 治疗成功至关重要.
- 在HNSCC护理的背景下,人们对及时访问PORT的障碍并不明白.
研究的目的:
- 在HNSCC患者中识别和分类及时启动PORT的障碍.
- 评估已识别的障碍与在手术后6周内接受PORT的可能性之间的关联.
- 确定在没有及时治疗的患者中PORT延迟的主要原因.
主要方法:
- 涉及成人HNSCC患者的前性队列研究,这些患者接受了PORT的指示手术.
- 通过患者自我报告和电子健康记录收集关于PORT障碍的数据.
- 对障碍数量/类别与及时启动 PORT 之间的关联进行分析.
主要成果:
- 只有41%的患者在推的6周时间内启动PORT.
- 每一个额外的障碍都显著降低了及时启动PORT的几率 (aOR=0.81).
- 术后不良反应 (aOR=0.17) 和护理协调不良 (41.3%的延迟) 是重要的障碍.
结论:
- 越来越多的障碍和特定类别,如外科手术期间的不良影响,阻碍了及时的 PORT.
- 糟糕的护理协调是PORT延迟的主要驱动因素.
- 干预措施应旨在减少障碍,提高外科手术质量,改善护理协调,以优化HNSCC治疗.
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