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在绝经后早期乳腺癌患者接受辅助内分泌疗法的骨健康管理的新模型 - - 预测和预防项目
Stefania Gori1, Alessandra Fabi2, Rossana Berardi3
1Medical Oncology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella, Verona, Italy.
Healthcare (Basel, Switzerland)
|December 30, 2025
概括
一种新的骨健康管理模式改善了早期乳腺癌患者接受必要的骨保护药物的比例. 这一举措加强了对接受内分泌治疗的绝经后妇女预防骨折的指导方针的遵守.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 意大利药物管理局 (AIFA) 2015年第589号决定 (注79) 规定双酸盐或登苏马布用于在绝经后早期乳腺癌 (EBC) 患者接受辅助内分泌治疗 (ET) 的初级骨折预防.
- 在2019年,对2015年AIFA建议的遵守率特别低,需要制定新的骨健康管理策略.
- 预测和预防项目旨在通过实施一种新的骨健康管理模式来解决这一差距.
研究的目的:
- 提高激素受体阳性 (HR+) 早期乳腺癌 (EBC) 患者接受适当骨健康管理的百分比.
- 评估一种新的骨健康管理模式在改善对双酸盐或苏马布治疗的坚持方面的有效性.
- 评估模型对关键绩效指标 (KPIs) 的影响,这些指标与骨健康评估和治疗启动有关.
主要方法:
- 实施新的骨健康管理模式,包括为多学科团队和骨健康专家提供培训.
- 评估两个关键绩效指标 (KPIs): 1) HR+EBC患者在辅助ET开始后30天内评估骨健康的比例,以及 2) HR+EBC患者在辅助ET开始后90天内接受双酸盐或苏马布的比例.
- 在10个参与的意大利癌症中心,基线 (T0) 和项目实施后12个月 (T3) 的KPI率的比较.
主要成果:
- 在9个报告癌症中心中的6个中,KPI-1和KPI-2率从基线 (T0) 到实施后12个月 (T3) 逐渐增加.
- 在剩余的3个癌症中心,KPI-1和KPI-2的基线率已经很高,在12个月后,这些率仍然保持在高水平.
- 观察到的改善归因于多学科团队的培训和新的骨健康管理模式的实施.
结论:
- 新的骨健康管理模式在增加骨健康评估和用双酸盐或苏马布治疗HR+EBC患者辅助ET的治疗率方面取得了成功.
- 该模型导致六个中心的坚持改善,并在已经具有强大的基线率的三个中心保持高坚持.
- 建议广泛采用该模型,以确保足够的骨健康管理,并减少绝经后HR+EBC患者的骨折率,这些患者接受辅助ET.
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