Population variations in the initial treatment of non-small-cell lung cancer
Population variations in the initial treatment of non-small-cell lung cancer
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DOI：
10.1200/jco.2004.02.051
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发表时间：
2004-08-15
影响因子：
45.3
通讯作者：
Lynch, CF
中科院分区：
文献类型：
--
作者：
Potosky, AL;Saxman, S;Lynch, CF
目的非小细胞肺癌（NSCLC）推荐治疗的传播尚未得到全面描述。我们报告的初始治疗的模式，重点是在接受推荐的治疗根据多个临床和非临床patient characteristics.MethodsA人口为基础的随机样本，新诊断的NSCLC患者诊断在10个不同的地理区域的差异调查收集于1996年（n = 898）。数据来自医疗记录。多元Logistic回归分析被用来评估使用推荐theraps.ResultsOverall，52%的NSCLC患者接受推荐的治疗。约69%、48%和41%的I期和II期、III期或IV期NSCLC患者分别接受了推荐的治疗。对于合并的所有分期，推荐治疗的使用与诊断时的年龄和分期显著负相关。推荐的治疗在白色患者中比黑人患者更常见，在已婚患者中比单身患者更常见。特定阶段的分析显示，随着年龄的增加，在早期NSCLC的诊断，建议的手术使用显着下降，并显着降低使用推荐的治疗（主要是放化疗）的第三阶段的黑人和西班牙裔患者相比，白色patients.ConclusionThe整体使用推荐的治疗NSCLC是低的。根据年龄、种族或民族以及婚姻状况，这些疗法的使用存在很大差异。需要将病历回顾与其他数据来源相结合的研究，以更好地了解患者偏好和医生判断对这些治疗变化的贡献。
PurposeDissemination of recommended therapies for non-small-cell lung cancer (NSCLC) have not been described comprehensively. We report the patterns of initial therapy focusing on the investigation of differences in receipt of recommended therapies according to multiple clinical and nonclinical patient characteristics.MethodsA population-based random sample of newly diagnosed NSCLC patients diagnosed in 10 separate geographic areas was collected in 1996 (n = 898). Data were obtained from medical records. Multiple logistic regression was used to assess the use of recommended therapies.ResultsOverall, 52% of NSCLC patients received recommended therapy. Approximately 69%, 48%, and 41% of patients with stages I and II, III, or IV NSCLC received recommended therapy, respectively. For all stages combined, the use of recommended therapy was significantly inversely associated with age and stage at diagnosis. Recommended therapy also was more common in white versus black patients, and in married versus single patients. Stage-specific analyses revealed a significant decline in the use of recommended surgery with increasing age at diagnosis for early-stage NSCLC only, and a significantly lower use of recommended therapy (primarily chemoradiotherapy) for stage III black and Hispanic patients compared with white patients.ConclusionThe overall use of recommended therapies for NSCLC is low. Large variations exist in the use of such therapies according to age, race or ethnicity, and marital status. Research combining medical record reviews with other sources of data is needed to better understand the contributions of both patient preferences and physician judgment to these treatment variations.