BREAST CANCER TREATMENT PROTOCOLS FOR HAWAII MINORITIES

乳腺癌是夏威夷的总头号恶性肿瘤，也是 夏威夷多民族妇女癌症相关死亡的原因。一定的 生活在夏威夷的少数族裔是乳腺癌死亡率最高的地区之一 以及在美国的生存。虽然在比例上更先进 最近的研究表明，确诊时的疾病可能会导致这些发现 提示与治疗相关的因素，如没有收到最多 有效的可用治疗是一个主要原因。这样做的目的是 少数族裔促进奖的提议是为了促进，在大学 夏威夷的机构层面，夏威夷的高风险介入 少数民族乳腺癌患者的治疗研究。该提案将重点放在 关于开发新的治疗方案，以确保获得 最先进的治疗方法，并且没有资格限制 国家合作小组协议。国家小组研究是 目前适用于所有阶段的乳腺癌，但不包括约70% 夏威夷患者的参与。基于表现 状态、年龄、合并症或其他情况。 该建议的具体目标是： (1)开发和评估基于新方案的治疗效果 无不合格标准，称为“非限制性治疗” 为夏威夷患有乳腺癌的少数族裔妇女提供“礼仪”； (2)开发病例查找系统，以识别所有新诊断的乳房 癌症患者和他们的持续护理医生50岁 提供参加以礼宾为基础的治疗的机会； (3)评估医生和患者拒绝参与的原因 以协议为基础的治疗。 要测量的患者结果变量包括方案的原因 偏差、治疗毒性以及治疗是否 按计划交付。毒性等级、治疗中断、剂量 修改和生活质量测量将记录治疗 宽容。肿瘤反应、肿瘤进展时间的测量 (治疗失败)，生存和生活质量的提高将 文件治疗效果。预测因素将包括年龄、表现 状况、合并症、种族、保险状况和距离 住处到癌症治疗现场。这项提议是迈向 一个长期目标，即减少不成比例的不利影响 夏威夷少数民族乳腺癌患者的死亡率和发病率 增加他们对适当治疗方法的参与。

Breast cancer is the overall leading malignancy in Hawaii and the leading cause of cancer-related death in Hawaii's multi-ethnic women. Certain minorities living in Hawaii have among the worst breast cancer mortality and survival in the United States. Although proportionally more advanced disease at diagnosis may contribute to these findings, recent studies suggest that therapy-related factors such as not receiving the most effective available treatments are a major cause. The purpose of this Minority Enhancement Award proposal is to promote, at the University of Hawaii institutional level, the involvement of Hawaii's high-risk minorities with breast cancer in treatment research. The proposal focuses on the development of novel treatment protocols which assure access to state-of-the-art treatment and do not have the eligibility restrictions of national cooperative group protocols. National group studies are currently available for all stages of breast cancer, but exclude about 70% of Hawaii's patients from participation.on the basis of performance status, age, comorbidity or other conditions. Specific aims of the proposal are to: (1) develop and assess the performance of new protocol-based treatments without ineligibility criteria referred to as "non-restrictive treatment protocols" for Hawaii's minority women with breast cancer; (2) develop a case finding system to identify all newly diagnosed breast cancer patients and their continuing care physicians 50 that they may be offered the opportunity to participate in protocol-based treatments; and (3) assess reasons why physicians and patients decline participation in protocol-based treatments. Patient outcome variables to be measured include reasons for protocol deviations, treatment toxicities and whether or not treatment was delivered as planned. Grades of toxicity, treatment interruptions, dose modifications and quality of life measures will document treatment tolerance. Measures of tumor response, time to tumor progression (treatment failure), survival and quality of life improvement will document treatment efficacy. Predictors will include age, performance status, comorbidity, ethnicity, insurance status, and distance from residence to cancer treatment site. The proposal is the first step towards a long-term objective which is to reduce the disproportional adverse mortality and morbidity of Hawaii's minorities with breast cancer through increasing their participation in appropriate treatment approaches.