概括
对500名患者的癌症化疗结果进行了评估. 结果表明,在临床试验或专门的癌症中心之外,广泛使用化疗是不合理的.
科学领域:
- 医学瘤学 医学瘤学
- 临床结果研究研究
- 癌症治疗的有效性 癌症治疗的有效性
背景情况:
- 1978年,对患者治疗结果的评估指向了一所大学教学医院的医疗瘤病房.
- 对前500名患者的人口统计和诊断数据的分析.
- 癌症类型分布与更广泛的区域统计数据的比较.
研究的目的:
- 为了确定患者的结果,转诊给医疗瘤病房.
- 评估癌症化疗的有效性和并发症.
- 评估细胞毒性药物使用的成本效益.
主要方法:
- 1978年连续500名患者的回顾性分析.
- 收集有关患者人口统计,诊断,接受治疗和存活率的数据.
- 治疗和未治疗组以及接受特定化疗方案的组之间的生存率的比较.
主要成果:
- 患者的中位年龄为58岁;50%的患者在诊断后6周内被转诊.
- 肺癌,乳腺癌,头癌,卵巢癌和丸癌的比例过高;胃肠道癌的比例不足.
- 在三分之一的患者中,不建议治疗. 在接受治疗的人中,有247人接受了细胞毒药物.
- 到1979年8月,接受治疗的患者中有56%和未接受治疗的患者中有52%死亡;平均存活时间为45周 (接受治疗) 和35周 (未接受治疗).
- 在接受"治愈性"或"辅助性"化疗的50名患者中,到1979年8月,只有17名患者死亡.
- 严重的并发症发生在8.8%的患者中. 细胞毒药物成本为212,000澳元 (9.3%的药房预算).
结论:
- 这项研究表明,癌症化疗的广泛应用在严格设计的临床试验或专门的癌症中心之外可能不合理.
- 这些发现凸显了医疗瘤学中需要仔细选择患者和评估治疗方案的必要性.
- 与化疗相关的成本和并发症率需要对其在癌症管理中的作用进行批判性评估.
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