Cohort study examining tamoxifen adherence and its relationship to mortality in women with breast cancer.
Cohort study examining tamoxifen adherence and its relationship to mortality in women with breast cancer.
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DOI：
10.1038/sj.bjc.6604758
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发表时间：
2008-12-02
影响因子：
8.8
通讯作者：
Fahey, T. P.
中科院分区：
文献类型：
--
作者：
McCowan, C.;Shearer, J.;Donnan, P. T.;Dewar, J. A.;Crilly, M.;Thompson, A. M.;Fahey, T. P.
增加他莫昔芬治疗的持续时间可以提高乳腺癌女性的生存率，但坚持服用他莫昔芬对死亡率的影响尚不清楚。这项研究调查了乳腺癌手术后服用他莫昔芬的女性是否遵守处方，以及遵守是否影响生存。对 1993 年至 2002 年间苏格兰泰赛德地区所有罹患乳腺癌的女性进行的一项回顾性队列研究与已兑现的处方记录相关联，以计算对他莫昔芬的依从性。生存分析用于确定依从性对全因死亡率的影响。研究队列共有 2080 名患者，其中 1633 名 (79%) 服用了他莫昔芬。中位使用时间为 2.42 年（IQR=1.04-4.89 年）。更长的持续时间与更好的生存率相关，但这随着时间的推移而变化。与 2.4 年病程相关的死亡率风险比为 0.85，95% CI=0.83-0.87。他莫昔芬的中位依从率为 93%（四分位数范围=84–100%）。依从性<80%与较差的生存率相关，风险比1.10，95% CI=1.001-1.21。他莫昔芬的坚持率较低，在随访 5 年或以上的患者中，只有 49% 的患者继续治疗 5 年。尽管有二分之一的女性没有完成推荐的 5 年疗程，但延长他莫昔芬的疗程可降低死亡风险。很大一部分女性对他莫昔芬的依从性较低，死亡风险增加。
Increasing duration of tamoxifen therapy improves survival in women with breast cancer but the impact of adherence to tamoxifen on mortality is unclear. This study investigated whether women prescribed tamoxifen after surgery for breast cancer adhered to their prescription and whether adherence influenced survival. A retrospective cohort study of all women with incident breast cancer in the Tayside region of Scotland between 1993 and 2002 was linked to encashed prescription records to calculate adherence to tamoxifen. Survival analysis was used to determine the effect of adherence on all-cause mortality. In all 2080 patients formed the study cohort with 1633 (79%) prescribed tamoxifen. The median duration of use was 2.42 years (IQR=1.04–4.89 years). Longer duration was associated with better survival but this varied over time. The hazard ratio for mortality in relation to duration at 2.4 years was 0.85, 95% CI=0.83–0.87. Median adherence to tamoxifen was 93% (interquartile range=84–100%). Adherence <80% was associated with poorer survival, hazard ratio 1.10, 95% CI=1.001–1.21. Persistence with tamoxifen was modest with only 49% continuing therapy for 5 years of those followed up for 5 years or more. Increased duration of tamoxifen reduces the risk of death, although one in two women do not complete the recommended 5-year course of treatment. A significant proportion of women have low adherence to tamoxifen and are at increased risk of death.
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影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
3.9
作者：
Dewar, JA;Stewart, HJ;MacDonald, TM
通讯作者：
MacDonald, TM
影响因子：
45.3
作者：
Partridge, AH;Wang, PS;Avorn, J
通讯作者：
Avorn, J
影响因子：
45.3
作者：
Demissie, S;Silliman, RA;Lash, TL
通讯作者：
Lash, TL
影响因子：
10.3
作者：
Fisher, B;Dignam, J;Lickley, HL
通讯作者：
Lickley, HL