Trends and Racial Differences in the Use of Androgen Deprivation Therapy for Metastatic Prostate Cancer
Trends and Racial Differences in the Use of Androgen Deprivation Therapy for Metastatic Prostate Cancer
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DOI：
10.1016/j.jpainsymman.2009.09.013
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发表时间：
2010-05-01
影响因子：
4.7
通讯作者：
Godley, Paul A.
中科院分区：
文献类型：
--
作者：
Carson, April P.;Howard, Daniel L.;Godley, Paul A.
上下文。雄激素剥夺疗法(ADT)被广泛用于治疗晚期前列腺癌的症状，并已被证明可以减缓疾病的进展。先前调查ADT使用的种族差异的研究报告了不一致的发现。这项研究的目的是评估ADT在转移性前列腺癌中的总体和分类(切除和黄体生成素释放激素(LHRH)激动剂)的使用趋势以及与接受治疗的时间相关的因素。从监测、流行病学和最终结果(SEER)癌症登记和医疗保险索赔数据库中获得了1991-1999年间7个SEER地区5,273名65岁及以上并被诊断为IV期前列腺癌的男性的数据。采用对数正态分布的加速失效时间回归模型，对ADT平均接收时间的影响因素进行分析。非裔美国人男性比白人男性在确诊后接受任何ADT的可能性更小(P<；0.001)。在接受ADT的时间上存在差异，非裔美国人男性接受切除(时间比[RR]=1.50；95%可信区间[CI]=1.03，2.17)或LHRH激动剂(TR值=1.42；95%CI=1.06，1.89)的平均时间比白人男性长。患有转移性前列腺癌的非裔美国人男性接受ADT的可能性显著低于白人男性，在接受治疗时，接受ADT的时间略长于白人男性，这对参与转移性前列腺癌姑息治疗的患者和医生来说是有意义的。J疼痛症状管理2010；39：872-881。(C)2010年美国癌症疼痛缓解委员会。爱思唯尔公司出版，版权所有。
Context. Androgen deprivation therapy (ADT) is widely used to manage the symptoms of advanced prostate cancer and has been shown to slow the progression of the disease. Previous research investigating racial differences in the use of ADT has reported inconsistent findings.Objectives. The purpose of this study was to assess use trends for ADT overall and by type (orchiectomy and luteinizing hormone-releasing hormone [LHRH] agonists) and the factors associated with time to receipt for metastatic prostate cancer.Methods. Data from the Surveillance, Epidemiology, and End Results (SEER) cancer registry and Medicare claims database were obtained for 5,273 men, aged 65 years and older and diagnosed with Stage IV prostate cancer during 1991-1999 from seven SEER regions. An accelerated failure time regression model with log-normal distribution was used to examine factors associated with mean time to receipt of ADT.Results. African-American men were less likely than white men to receive any ADT after diagnosis (P< 0.001). Differences were noted in the time to receipt of ADT, with African-American men having a longer mean time to receipt of orchiectomy (time ratio [TR] = 1.50; 95% confidence interval [Cl] = 1.03, 2.17) or LHRH agonist (TR = 1.42; 95% CI =1.06, 1.89) than white men.Conclusion. African-American men with metastatic prostate cancer were significantly less likely to receive ADT and, when treated, had a slightly longer time to receipt than white men, which has implications for patients and physicians involved in the palliative management of metastatic prostate cancer. J Pain Symptom Manage 2010;39:872-881. (C) 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.