ADJUVANT TAMOXIFEN THERAPY IN OLD AGE

描述：这是一份来自波士顿大学的新申请 阐述三苯氧胺辅助治疗在老年乳房患者中的作用 癌症。尽管人们对使用的变化很感兴趣 老年患者乳房切除术与保乳手术+放射治疗的比较 对于女性来说，几乎没有系统地研究辅助治疗的使用 在临床试验之外。化疗在老年绝经后妇女中的应用 女性仍有争议，然而，佐剂他莫昔芬已被证明 有效地减少老年妇女的复发和死亡率，没有 疗效因年龄而明显降低，包括那些70岁的妇女 而且年纪也更大。尽管已发布的指南建议使用 他莫昔芬治疗绝经后女性肿瘤1厘米，有证据表明 老年妇女接受的治疗不足，他莫昔芬的使用率 停产不是无关紧要的。 这项申请提出了一项针对女性的前瞻性观察性研究 患有I期(&>1厘米)和II期乳腺癌的年龄及其 在四个不同地域的不同医疗保健环境中的医生 地区(洛杉矶、明尼苏达州、罗德岛州和西部 北卡罗来纳州)，他莫昔芬的使用率不同。四个主要问题 这项研究的目的是找出医生信念的预测因素 关于老年患者三苯氧胺辅助治疗的益处和风险 女性；2)患者对辅助剂的益处和风险的信念 他莫昔芬治疗和这些信念的变化在一年的时间里 时间；3)医生开他莫昔芬的处方；4)患者遵守 在他莫昔芬处方后3个月和12个月进行他莫昔芬治疗。 这项研究的两个次要目标是比较他莫昔芬治疗和 未经治疗的妇女在以下方面：1)症状的患病率通常 归因于他莫昔芬治疗和2)与健康相关的生活质量。

DESCRIPTION: This is a new application from Boston University that addresses the role of adjuvant tamoxifen therapy in older women with breast cancer. Although there has been interest in variations in the use of mastectomy vs. breast-conserving surgery + radiation therapy among older women, there has been little systematic study of the use of adjuvant therapy outside of clinical trials. The use of chemotherapy in older postmenopausal women remains controversial, however, adjuvant tamoxifen has been proven to be efficacious in reducing recurrences and mortality in older women, with no apparent decrement in efficacy by age, including those women 70 years of age and older. In spite of published guidelines recommending the use of tamoxifen in postmenopausal women with tumors > 1 cm, there is evidence that older women are being under-treated and that the rates of tamoxifen discontinuance are not inconsequential. This application proposes a prospective observational study of women > 70 years of age with stage I (> 1 cm) and stage II breast cancer and of their physicians in diverse health care settings in four different geographic regions (Los Angeles, the states of Minnesota and Rhode Island, and Western North Carolina), with differing rates of tamoxifen use. The four primary aims of this research are to identify predictors of 1) physicians' beliefs regarding the benefits and risks of adjuvant tamoxifen therapy in older women; 2) patients' beliefs regarding the benefits and risks of adjuvant tamoxifen therapy and of changes in these beliefs over a one-year period of time; 3) physicians' prescribing of tamoxifen; and 4) patients' adherence to tamoxifen therapy at three and twelve months post tamoxifen prescription. The two secondary aims of the research are to compare tamoxifen-treated and untreated women with respect to: 1) the prevalence of symptoms commonly attributed to tamoxifen therapy and 2) health-related quality of life.