Use of intravenous bisphosphonates in older women with breast cancer
Use of intravenous bisphosphonates in older women with breast cancer
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DOI：
10.1634/theoncologist.2007-0200
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发表时间：
2008-05-01
期刊：
影响因子：
5.8
通讯作者：
Goodwin, James S.
中科院分区：
文献类型：
--
作者：
Giordano, Sharon H.;Fang, Shenying;Goodwin, James S.
介绍。我。 v. 双磷酸盐可减少乳腺癌骨转移女性的骨骼事件，但人们对双磷酸盐使用的流行率和持续时间知之甚少。方法。从监测、流行病学和最终结果-医疗保险数据库中确定年龄≥ 65 岁并在 1995 年至 2002 年期间被诊断患有浸润性乳腺癌的患者。医疗保健通用程序编码系统代码用于识别接受帕米膦酸和唑来膦酸治疗的患者。描述性统计数据用于描述使用模式。进行多变量分析以确定双膦酸盐使用的预测因素。结果。总共纳入了 55,864 名患有乳腺癌的女性，并进行了 307,467 人年的随访。总体而言，患有所有阶段乳腺癌的女性中有 1.26% 接受了 i 治疗。五、双膦酸盐。 2004年，2%的乳腺癌患者和32%的晚期疾病患者接受了双磷酸盐治疗。 2004 年，大约三分之二接受双膦酸盐治疗的患者接受了唑来膦酸治疗，三分之一接受了帕米膦酸治疗。多变量分析显示，>= 75 岁的患者接受双膦酸盐治疗的可能性较小（75-79 岁与 65-69 岁：比值比 [OR]，0.81；95% 置信区间 [CI]，0.70-0.93；80 +岁与 65-69 岁：OR，0.49；95% CI，0.42-0.57）。随着时间的推移，双膦酸盐的使用急剧增加。大多数活着的患者继续接受 i 治疗。 v. 双磷酸盐一旦开始使用（1 年时为 83%，3 年时为 64%，5 年时为 50%），但开始 i 后的中位生存时间。 v.双磷酸盐仅21个月。结论。我。 v. 双磷酸盐似乎在转移性乳腺癌患者中未得到充分利用，特别是在年龄 > 75 岁的患者中。
Introduction. i. v. bisphosphonates reduce skeletal events in women with bone metastases from breast cancer, but little is known about the prevalence and duration of bisphosphonate use.Methods. Patients were identified from the Surveillance, Epidemiology, and End Results-Medicare database who were aged >= 65 years and were diagnosed with invasive breast cancer in 1995-2002. Healthcare Common Procedure Coding System codes were used to identify patients treated with pamidronate and zoledronic acid. Descriptive statistics were used to describe patterns of use. Multivariate analyses were performed to determine the predictors of bisphosphonate use.Results. In total, 55,864 women with breast cancer were included, with 307,467 person-years of follow-up. Overall, 1.26% of women with all stages of breast cancer received i. v. bisphosphonates. In 2004, 2% of all breast cancer patients and 32% of patients with distant stage disease received bisphosphonates. Approximately two thirds of patients treated with bisphosphonates received zoledronic acid and one third received pamidronate in 2004. Multivariate analyses showed that patients who were >= 75 years old were less likely to receive bisphosphonates ( 75-79 years versus 65-69 years: odds ratio [OR], 0.81; 95% confidence interval [CI], 0.70-0.93; 80 + years versus 65-69 years: OR, 0.49; 95% CI, 0.42-0.57). The use of bisphosphonates dramatically increased over time. The majority of living patients were continued on i. v. bisphosphonates once started (83% at 1 year, 64% at 3 years, 50% at 5 years), but the median survival time after initiation of i. v. bisphosphonates was only 21 months.Conclusions. i. v. bisphosphonates appear to be underused in patients with metastatic breast cancer, particularly among those patients > 75 years of age.