Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
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DOI：
10.1097/coc.0b013e31829378f9
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发表时间：
2015-06
期刊：
影响因子：
--
通讯作者：
Guadagnolo BA
中科院分区：
文献类型：
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作者：
Huo J;Du XL;Lairson DR;Chan W;Jiang J;Buchholz TA;Guadagnolo BA
研究转移性黑色素瘤患者在生命末期对放射治疗、化疗、手术和临终关怀的利用模式。我们在2000年1月1日至2007年12月31日期间确定了816名65岁或以上的医疗保险受益人，他们患有病理证实的转移性恶性黑色素瘤。我们评估了社会人口统计学和卫生服务特征与临终关怀、化疗、手术和放射治疗的使用之间的趋势和关联。我们发现转移性黑色素瘤患者的手术使用率从2000年的13%增加到2007年的30%（趋势P = 0.03），化疗（P = 0.43）或放疗（P = 0.46）的使用没有显著波动。老年患者不太可能接受放射治疗或化疗。临终关怀的使用率从2000年的61%上升到2007年的79%（趋势P = 0.07）。短期（1 - 3天）临终关怀使用的入组人数增加，而长期临终关怀（≥ 4天）保持稳定。居住在SEER东北和南部地区的患者不太可能接受手术。参加长期临终关怀的患者使用的化疗，手术和放射治疗显着减少。手术和临终关怀的使用增加了多年的这项研究，而化疗和放疗的使用仍然是一致的患者诊断为转移性黑色素瘤。
To examine the patterns of utilization of radiation therapy, chemotherapy, surgery, and hospice at the end of life-care for patients diagnosed with metastatic melanoma. We identified 816 Medicare beneficiaries 65 years of age or older with pathologically confirmed metastatic malignant melanoma between January 1, 2000 and December 31, 2007. We evaluated trends and associations between sociodemographic and health services characteristics and the use of hospice care, chemotherapy, surgery, and radiation therapy. We found increasing use of surgery for patients with metastatic melanoma from 13% in 2000 to 30% in 2007 (P=0.03 for trend), no significant fluctuation in use of chemotherapy (P=0.43) or radiation therapy (P=0.46). Older patients were less likely to receive radiation therapy or chemotherapy. The use of hospice care increased from 61% in 2000 to 79% in 2007 (P =0.07 for trend). Enrollment in short-term (1–3 days) hospice care use increased, while long-term hospice care (≥ 4 days) remained stable. Patients living in the SEER Northeast and South regions were less likely to undergo surgery. Patients enrolled in long-term hospice care used significantly less chemotherapy, surgery and radiation therapy. Surgery and hospice care use increased over the years of this study while the use of chemotherapy and radiation therapy remained consistent for patients diagnosed with metastatic melanoma.