对于前列腺癌患者的骨修改剂启动的提供者间变化.
Aaron P Mitchell1,2,3, Andrew Salner4, Paul Palyca5
1Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY.
JCO oncology practice
|November 3, 2025
概括
过度使用骨修饰剂在转移性割敏感前列腺癌 (mCSPC) 中是罕见的. 然而,在转移性割抵抗性前列腺癌 (mCRPC) 中的适当使用在提供者之间存在显著差异,这表明需要进行干预以改善护理.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 临床指南推用于转移性割抵抗性前列腺癌 (mCRPC) 的骨修饰剂 (BMA),以预防骨事件.
- 指南建议不使用BMA治疗转移性割敏感前列腺癌 (mCSPC),因为在这种情况下缺乏已证明的益处.
- 之前的研究发现了BMA使用差距,但供应商之间的差异仍然不太清楚.
研究的目的:
- 评估BMA使用前列腺癌与骨转移的供应商之间的差异.
- 评估BMA在mCSPC中的过度使用和mCRPC中的适当使用.
主要方法:
- 153名前列腺癌和骨转移患者 (2020-2021) 的多中心,回顾性队列研究.
- 通过图表审查收集的数据遍及美国东北部三个卫生系统 (两个社区,一个学术).
- 评估结果:在CSPC中过度使用BMA (在CRPC之前没有并发性征兆) 和在CRPC中适当使用 (在CRPC出现后).
主要成果:
- 在CSPC期间过度使用BMA很少 (16%的95名可评估患者),系统间的差异很小 (13-21%).
- 在患有CRPC的患者中,适当的BMA使用率为44% (24/55).
- 对mCRPC的适当BMA使用观察到显著的系统间变化 (22%至54%).
结论:
- 在mCSPC中过度使用BMA似乎很少见,可能是由于撤销实施的努力.
- 在临床医生和卫生系统之间,在适当的BMA使用mCRPC方面存在实质性的差异.
- 需要针对符合指导方针的治疗进行干预,以优化患者的治疗结果.
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