Management and survival of patients with lung cancer in Scotland diagnosed in 1995: results of a national population based study
Management and survival of patients with lung cancer in Scotland diagnosed in 1995: results of a national population based study
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DOI：
10.1136/thorax.56.3.212
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发表时间：
2001-03-01
期刊：
影响因子：
10
通讯作者：
Milroy, R
中科院分区：
文献类型：
--
作者：
Gregor, A;Thomson, CS;Milroy, R
苏格兰肺癌患者的预后很差，而且没有改善。这项研究的目的是记录因素的影响，转诊，诊断评估，治疗，和生存在肺癌patients with lung cancer. Methods，1995年诊断的患者被确定从苏格兰癌症登记处和他们的病历进行了审查。在91.2%的潜在符合条件的病例中有足够的记录。结果--在1995年，苏格兰肺癌患者的显微镜检查证实率很高（74.1%）和75.3%由呼吸科医生评估;然而，只有56.8%的患者接受了积极的治疗（切除10.7%，放疗35.8%，化疗16.1%），2.9%的患者参加了临床试验。生存率较差，中位生存期为3.6个月; 21.1%（95% CI 19.8%-22.4%）的患者在1年时存活，7.0%（95% CI 6.2%-7.8%）的患者在3年时存活。呼吸内科医生，肿瘤科医生，或胸外科医生的管理是一个独立的预测获得潜在的治愈性治疗和更好的survival. Conclusion，这个国家的人口为基础的研究表明，低使用的治疗，生存率低，和影响的过程中的护理生存，实施循证指南将需要在实践中的重大变化。增加接受治疗的患者数量可能会提高生存率。
Background-The prognosis of patients with lung cancer in Scotland is poor and not improving. This study was designed to document factors influencing referral, diagnostic evaluation, treatment, and survival in patients with lung cancer.Methods-Patients diagnosed during 1995 were identified from the Scottish Cancer Registry and their medical records were reviewed. Adequate records were available in 91.2% of all potentially eligible cases.Results-In 1995, patients in Scotland with lung cancer had a high rate of microscopic verification (74.1%) and 75.3% were assessed by a respiratory physician; however, only 56.8% received active treatment (resection 10.7%, radiotherapy 35.8%, chemotherapy 16.1%) and 2.9% participated in a clinical trial. Survival was poor with a median of 3.6 months; 21.1% (95% CI 19.8% to 22.4%) were alive at I year and 7.0% (95% CI 6.2% to 7.8%) at 3 years. Management by respiratory physician, oncologist, or thoracic surgeon was an independent predictor of access to potentially curative treatment and better survival.Conclusion-This national population based study demonstrates low use of treatment, poor survival, and the influence of process of care on survival, Implementation of evidence-based guidelines will require substantial changes in practice. Increasing the number of patients who receive treatment may improve survival.