与治疗延迟相关的因素 宫癌患者接受终极化疗和支臂疗法治疗
Sarah S Lee1, Kara Banson2, Harika Koduru2
1New York University Grossman School of Medicine, NYU Langone Health, Laura and Isaac Perlmutter Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, New York, NY, USA.
概括
对于宫癌患者来说,延迟开始治疗显著恶化了整体存活率. 公共医院的患者面临更长的延迟,但结果更好,突出了护理获取和协调方面的差异. 改善护理协调对于及时治疗至关重要.
科学领域:
- 妇科瘤学 妇科瘤学
- 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:
- 宫癌治疗,包括化学辐射和支臂疗法,需要及时启动以获得最佳结果.
- 治疗延迟可能是由各种人口,临床和系统因素引起的.
- 了解这些延迟对于改善患者存活率和护理公平性至关重要.
研究的目的:
- 确定与宫癌患者延迟开始治疗有关的人口和临床因素.
- 评估延迟治疗对瘤结局的影响,特别是无进展和整体存活率.
- 探索公共和私人医院转诊之间治疗延迟的差异.
主要方法:
- 在2009-2019年期间对122名患有IB2-IVA期子宫癌的患者进行了回顾性队列研究.
- 在8周内 (早期) 与8周后 (延迟) 开始治疗的患者的比较.
- 后勤和考克斯回归分析以确定与延迟和生存结果相关的因素.
主要成果:
- 38%的患者经历了延迟的治疗开始 (中位数为76天,而早期开始者则为35天).
- 公立医院转诊更有可能出现延迟 (OR 4.31) 但呈现的疾病进展较慢,总体存活率更好.
- 开始治疗的每10天延迟都与7%的死亡风险增加有关 (HR 1.07).
结论:
- 延迟开始治疗与宫癌患者的生存率下降显著相关.
- 系统因素和转诊模式,特别是诊断工作延迟,是治疗延迟的主要驱动因素.
- 改善护理协调至关重要,以确保公平及时获得宫癌治疗.
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