Fallowfield L, Atkins L, Catt S, Cox A, Coxon C, Langridge C, Morris R, Price M
Sussex Psychosocial Oncology Group, Cancer Research UK, Brighton and Sussex Medical School, University of Sussex, Sussex, UK.
Ann Oncol. 2006 Feb;17(2):205-10. doi: 10.1093/annonc/mdj044. Epub 2005 Oct 20.
Endocrine therapies for advanced breast cancer include tablets and intramuscular injections. When treatments have similar efficacy and tolerability profiles, addressing preferences about routes of administration is important.
Two hundred and eight women>2 years post-breast cancer diagnosis were interviewed about their preferences for daily tablets or monthly intramuscular injections. Health-care professionals treating the women estimated patients' preferences.
Sixty-three per cent of patients preferred tablets, 24.5% preferred the injection and 12.5% had no preference. The most cited reasons for tablet preference were convenience and dislike of needles; for injection preference, adherence and convenience. Variables associated with preferences were body mass index, educational level, attitudes towards injections and efficacy perceptions. Estimates about patients' preferences by health-care professionals varied widely. When asked to imagine scenarios where injections produced fewer hot flushes, or where two injections monthly improved efficacy, injection preference increased to 60.6% and 74.5%, respectively. Disturbingly, approximately 50% of patients admitted they sometimes forgot or chose not to take their current oral medication.
The majority of breast cancer patients preferred hormone therapy via daily tablets rather than monthly injections. Information about side-effects or improved efficacy altered these preferences. Adherence to treatment cannot be assumed; patients' preferences about drug administration may influence this.
晚期乳腺癌的内分泌治疗包括口服片剂和肌肉注射。当治疗具有相似的疗效和耐受性时，了解患者对给药途径的偏好很重要。
对208名乳腺癌诊断后超过2年的女性进行访谈，了解她们对每日口服片剂或每月肌肉注射的偏好。治疗这些女性的医护人员估计患者的偏好。
63%的患者更喜欢片剂，24.5%更喜欢注射，12.5%无偏好。更喜欢片剂的最常见原因是方便和不喜欢打针；更喜欢注射的原因是依从性和方便。与偏好相关的变量有体重指数、教育水平、对注射的态度和疗效认知。医护人员对患者偏好的估计差异很大。当被要求设想注射产生较少潮热的情景，或每月两次注射提高疗效的情景时，注射偏好分别增至60.6%和74.5%。令人不安的是，约50%的患者承认他们有时会忘记或选择不服用当前的口服药物。
大多数乳腺癌患者更喜欢通过每日口服片剂而非每月注射进行激素治疗。关于副作用或疗效改善的信息改变了这些偏好。不能假定患者会坚持治疗；患者对药物给药的偏好可能会影响这一点。
