Timing and Delays in Breast Cancer Evaluation and Treatment.
Timing and Delays in Breast Cancer Evaluation and Treatment.
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DOI：
10.1245/s10434-018-6615-2
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发表时间：
2018-10
影响因子：
3.7
通讯作者：
Bleicher RJ
中科院分区：
文献类型：
--
作者：
Bleicher RJ
即使是乳腺癌治疗中的小延迟也是患者经常表达的担忧。有关这一主题的知识对于临床医生适当和现实地为患者提供咨询，同时优化护理非常重要。虽然关于化疗和放疗时间的数据和质量指标已经存在了一段时间，但关于手术治疗的数据是最近的，没有标准。这篇综述的目的是讨论我们目前对治疗时间与结果关系的认识。在我们目前化疗和放疗的时间依赖性标准的背景下，对已发表的关于延迟和最佳治疗时间的医学文献进行了综述。还讨论了手术文献和缺乏时间依赖性手术标准的问题，提出了一个可能的标准。延迟的风险因素很多，肿瘤倍增时间既难以确定，也无助于评估较长治疗时间对结果的影响。评估部分也有时间成本，并且与患者的检查是不可分割的。虽然已发表的文献缺乏统一性，但新兴数据强烈建议每种模式的最佳时间，支持当前的质量措施。手术、化疗和放疗的时间都对结果有可测量的影响，包括无病生存期、疾病特异性生存期和总生存期。延迟的影响比通常认为的要小，但对结果有可衡量的影响。从诊断开始的最佳时间是手术<90天，化疗<120天，如果进行化疗，放疗<365天。
Even small delays in the treatment of breast cancer are a frequently expressed concern of patients. Knowledge about this subject is important for clinicians to counsel patients appropriately and realistically, while also optimizing care. Although data and quality measures regarding time to chemotherapy and radiotherapy have been present for some time, data regarding surgical care is more recent and no standard exists. This review was written to discuss our current knowledge about the relationship of treatment times to outcomes. The published medical literature addressing delays and optimal times to treatment was reviewed in the context of our current time-dependent standards for chemotherapy and radiotherapy. The surgical literature and the lack of a time-dependent surgical standard were also discussed, suggesting a possible standard. Risk factors for delay are numerous, and tumor doubling times are both difficult to determine and unhelpful in assessing the impact of longer treatment times on outcomes. Evaluation components also have a time cost, and are inextricable from the patient’s workup. Although the published literature has lack of uniformity, optimal times to each modality are strongly suggested by emerging data, supporting the current quality measures. Times to surgery, chemotherapy and radiotherapy all have a measurable impact on outcomes, including disease-free survival, disease-specific survival, and overall survival. Delays have less of an impact than often thought, but have a measurable impact on outcomes. Optimal times from diagnosis are <90 days for surgery, <120 days for chemotherapy, and, where chemotherapy is administered, <365 days for radiotherapy.
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影响因子：
3.9
作者：
Abdel-Rahman, Omar
通讯作者：
Abdel-Rahman, Omar
DOI：
10.1016/j.ijrobp.2006.03.048
发表时间：
2006-08-01
影响因子：
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DOI：
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发表时间：
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影响因子：
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作者：
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通讯作者：
QUIRT, CF
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影响因子：
8.8
作者：
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通讯作者：
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影响因子：
8.8
作者：
LAIRD, A K
通讯作者：
LAIRD, A K