BREAST CANCER TREATMENT PROTOCOLS FOR HAWAII MINORITIES

乳腺癌是夏威夷的主要恶性肿瘤， 导致夏威夷多种族女性癌症相关死亡的原因。某些 居住在夏威夷的少数民族是乳腺癌死亡率最高的地区之一 在美国的生存。虽然在比例上更先进 最近的研究表明， 这表明，治疗相关的因素，如没有接受最 有效的治疗方法是主要原因。 这样做的目的 少数民族促进奖的建议是为了促进，在大学 夏威夷机构层面，介入夏威夷的高风险 少数民族乳腺癌治疗研究。提案重点 制定新的治疗方案， 国家的最先进的治疗，并没有资格限制， 国家合作小组议定书。 国家小组研究是 目前可用于乳腺癌的所有阶段，但排除约70% 的夏威夷的病人从参与。根据性能 状态、年龄、合并症或其他状况。 该提案的具体目标是： (1)开发和评估新的基于方案的治疗的性能 没有被称为“非限制性待遇”的不合格标准 为患有乳腺癌的夏威夷少数民族妇女制定“治疗方案”; (2)建立病例发现系统，以识别所有新诊断的乳腺癌 癌症患者和他们的持续护理医生50，他们可能是 提供参与基于方案的治疗的机会;以及 (3)评估医生和患者拒绝参与的原因 基于协议的治疗。 待测量的患者结局变量包括方案原因 偏差、治疗毒性以及治疗是否 按计划交付。 毒性分级、治疗中断、剂量 修改和生活质量的措施将记录治疗 宽容肿瘤缓解指标，至肿瘤进展时间 （治疗失败），生存率和生活质量的改善将 记录治疗效果。预测因素将包括年龄，性能 身份、国籍、种族、保险状况和距离 癌症治疗现场。该提案是迈向 长期目标是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.