Barnholtz-Sloan Jill S, Maldonado John L, Williams Vonetta L, Curry William T, Rodkey Elizabeth A, Barker Frederick G, Sloan Andrew E
Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106-5065, USA.
J Neurooncol. 2007 Nov;85(2):171-80. doi: 10.1007/s11060-007-9405-4. Epub 2007 May 26.
Few studies have assessed racial/ethnic differences in survival after primary glioblastoma diagnosis. We investigate these differences, incorporating information on White, Hispanics and Asians, as well as White, non-Hispanics and Blacks, among elderly individuals with a primary glioblastoma utilizing the population-based Surveillance, Epidemiology and End Results (SEER) Program-Medicare linked database.
A total of 1,530 individuals diagnosed > = 66 years of age from 6/1/91 to 12/31/99 in the SEER data were linked with Medicare information from 1/1/91 to 12/31/01. All individuals had Medicare Parts A and B and were non-HMO for 6 months before and 12 months after diagnosis to gather pre-diagnosis co-morbidities and post-diagnosis first course of treatment. Survival differences by race/ethnicity and by race/ethnicity stratified by treatment type and/or median household income were examined using Kaplan-Meier and multivariable Cox proportional hazards models.
Significant racial/ethnic differences existed between White, non-Hispanics and Blacks in marital status, income and SEER registry region for the entire US. In analysis limited to the West region, significant racial/ethnic differences existed for income only. Overall there were no differences in survival between White, non-Hispanics and Blacks, however, in analysis limited to the West region, Asians had a lower risk of death compared to White, non-Hispanics [HR = 0.67, 95% CI (0.43, 1.03)]. Asians who had multiple treatments also had a lower risk of death compared to White, non-Hispanics [HR = 0.65, 95% CI (0.41, 1.01)].
Racial/ethnic differences in survival after primary glioblastoma diagnosis exist and may be partially explained by racial/ethnic differences in treatment and income.
很少有研究评估原发性胶质母细胞瘤诊断后的生存种族/民族差异。我们利用基于人群的监测、流行病学和最终结果（SEER）计划 - 医疗保险链接数据库，对患有原发性胶质母细胞瘤的老年人中的白人、西班牙裔和亚裔以及白人、非西班牙裔和黑人进行调查，以研究这些差异。
1991年6月1日至1999年12月31日在SEER数据中诊断出年龄≥66岁的1530名个体与1991年1月1日至2001年12月31日的医疗保险信息相关联。所有个体均拥有医疗保险A部分和B部分，并且在诊断前6个月和诊断后12个月是非健康维护组织（HMO）成员，以收集诊断前的合并症和诊断后的首个疗程治疗信息。使用Kaplan - Meier和多变量Cox比例风险模型检查按种族/民族以及按治疗类型和/或家庭收入中位数分层的种族/民族的生存差异。
在美国全国范围内，白人、非西班牙裔和黑人在婚姻状况、收入和SEER登记地区存在显著的种族/民族差异。在仅限于西部地区的分析中，仅在收入方面存在显著的种族/民族差异。总体而言，白人、非西班牙裔和黑人之间的生存没有差异，然而，在仅限于西部地区的分析中，与白人、非西班牙裔相比，亚裔死亡风险较低[风险比（HR）= 0.67，95%置信区间（CI）（0.43，1.03）]。接受多种治疗的亚裔与白人、非西班牙裔相比死亡风险也较低[HR = 0.65，95% CI（0.41，1.01）]。
原发性胶质母细胞瘤诊断后的生存存在种族/民族差异，并且可能部分由治疗和收入方面的种族/民族差异所解释。
