Factors that determine the treatment for local and regional prostate cancer
Factors that determine the treatment for local and regional prostate cancer
复制标题
DOI：
10.1097/00005650-199602000-00007
复制
发表时间：
1996-02-01
期刊：
影响因子：
3
通讯作者：
Retchin, SM
中科院分区：
文献类型：
--
作者：
Desch, CE;Penberthy, L;Retchin, SM
本文评估了局部区域期前列腺癌老年男性患者接受的治疗类型中合并症和非临床因素的重要性。对弗吉尼亚癌症登记处数据的多变量分析与医疗保险索赔文件、地区资源文件和 1990 年人口普查数据相关联。研究人员对 1985 年至 1989 年间诊断出的 3117 名局部区域分期前列腺癌男性进行了研究。1985 年至 1989 年间，前列腺癌的手术和放疗频率有所上升（手术为 12.5% 至 18.5%，P < 0.001；放疗为 25% 至 32%，P < 0.001）。年龄是治疗选择最重要的预测因素； 65 至 69 岁男性中有 26% 未接受治疗，而 85 岁或以上男性中有 63% 未接受治疗（P < 0.001）。种族、居住地（农村与城市）和合并症也是预测初始治疗的重要因素。使用逻辑回归，评估了三种治疗方案。年龄（比值比 [OR] .51；99% 置信区间 [CI] = .43, .60）、合并症（OR .72；99% CI .63, .82）、收入（OR 1.14；99% CT 1.01, 1.28）、居住地（OR .65；99% CI .48, .87）、诊断年份（或 1.15；99% CI 1.07， 1.23）所有这些都与治疗与不治疗独立相关。对于手术与放疗，年龄（OR .40；99% CI .27，.57）、种族（OR 2.92；99% CI 1.65，5.15）和教育程度（OR 1.75；99% CI 1.31，2.34）是重要因素。对于激素/睾丸切除术与手术/放射治疗，年龄（OR 5.19; 99% CI 3.84, 7.01）、合并症（OR 1.28; 99% CI 1.03, 1.58）、与放射肿瘤科医生的距离（OR .89; 99% CI .80, .99）和诊断年份（OR .89; 99% CI .79, 1.00) 显着。 1985 年至 1989 年间，接受前列腺癌手术和放射治疗的男性人数有所增加。在此期间，年龄在所有治疗决策中始终发挥着重要作用。其他因素，如合并症、种族、社会经济地位和距离，也是重要的考虑因素，具体取决于治疗方案。
This article assesses the significance of comorbid and nonclinical factors in type of treatment received by elderly male patients with local-regional stage prostate cancer. Multivariate analysis of data from the Virginia Cancer Registry was linked to Medicare claim files, the Area Resource File, and 1990 Census Data. The type of initial treatment received was studied in 3117 men with local-regional staged prostate cancer diagnosed from 1985 to 1989. The frequency of surgical and radiation therapy for prostate cancer rose between 1985 and 1989 (12.5% to 18.5% for surgery, P < 0.001; 25% to 32% for radiation, P < 0.001). Age was the most important predictor of therapeutic choice; no therapy was given to 26% of men 65 to 69 years old versus 63% of men 85 years or older P < 0.001). Race, residence (rural versus urban), and comorbidity were also strong factors in predicting initial therapy. Using logistic regression, three treatment alternatives were evaluated. Age (odds ratio [OR] .51; 99% confidence interval [CI] = .43, .60), comorbidity (OR .72; 99% CI .63, .82), income (OR 1.14; 99% CT 1.01, 1.28), residence (OR .65; 99% CI .48, .87), diagnosis year (OR 1.15; 99% CI 1.07, 1.23) all were associated independently with treatment versus no treatment. For surgery versus radiation, age (OR .40; 99% CI .27, .57), race (OR 2.92; 99% CI 1.65, 5.15) and education (OR 1.75; 99% CI 1.31, 2.34) were significant factors. For hormonal/orchiectomy versus surgery/radiation, age (OR 5.19; 99% CI 3.84, 7.01), comorbidity (OR 1.28; 99% CI 1.03, 1.58), distance to radiation oncologist (OR .89; 99% CI .80, .99), and diagnosis year (OR .89; 99% CI .79, 1.00) were significant. The number of men receiving surgical and radiation treatments for prostate cancer increased between 1985 and 1989. During that period, age consistently played a significant role in all therapeutic decisions. Other factors, such as comorbidity, race, socioeconomic status, and distance, also were important considerations, depending on the treatment alternative.