影响乳腺癌女性接受化疗的因素。
Factors affecting receipt of chemotherapy in women with breast cancer.
机构信息
Exponent Health Sciences, Menlo Park, CA, USA;
出版信息
Int J Womens Health. 2010 Aug 9;2:107-22. doi: 10.2147/ijwh.s9125.
AIMS
To review literature describing factors associated with receipt of chemotherapy for breast cancer, to better understand what factors are most relevant to women's health and whether health disparities are apparent, and to assess how these factors might affect observational studies and outcomes research. Patterns of care for metastatic breast cancer, for which no standard-of-care exists, were of particular interest.
METHODS
Relevant studies written in English, Italian, French, or Spanish, published in 2000 or later, were identified through MEDLINE and reviewed. Review articles and clinical trials were excluded; all observational studies and surveys were considered. Articles were reviewed for any discussion of patient characteristics, hospital/physician/insurance characteristics, psychosocial characteristics, and clinical characteristics affecting receipt of chemotherapy by breast cancer patients.
RESULTS
In general, factors associated with increased likelihood of receiving chemotherapy included younger age, being Caucasian, having good general health and few co-morbidities, having more severe clinical disease, having responded well to previous treatment, and having breast cancer that is estrogen- or progesterone-receptor-negative. Many of the clinical factors found to increase the likelihood of receiving chemotherapy were consistent with current oncology guidelines. Of the relevant 19 studies identified, only six (32%) reported data specific to metastatic cancer; most studies aggregated women with stage I-IV for purposes of analysis.
CONCLUSION
Studies of patterns of care in breast cancer treatment can help identify challenges in health care provided to particular subgroups of women and can aid researchers in designing studies that account for such factors in clinical and outcomes research. Although scarce, studies evaluating only women with metastatic breast cancer indicate that factors affecting decisions related to receipt of chemotherapy are similar across stage for this disease.
目的
回顾描述与乳腺癌化疗接受相关的因素的文献，以更好地了解哪些因素与女性健康最相关，是否存在健康差异，并评估这些因素如何影响观察性研究和结果研究。特别关注转移性乳腺癌的治疗模式，因为这种疾病没有标准的治疗方法。
方法
通过 MEDLINE 确定并回顾了 2000 年或之后以英文、意大利文、法文或西班牙文撰写的相关研究。排除综述文章和临床试验；所有观察性研究和调查都被认为是相关的。文章回顾了影响乳腺癌患者接受化疗的任何患者特征、医院/医生/保险特征、心理社会特征和临床特征的讨论。
结果
一般来说，与接受化疗可能性增加相关的因素包括年龄较小、白种人、一般健康状况良好且合并症较少、临床疾病较严重、对先前治疗反应良好，以及患有雌激素或孕激素受体阴性的乳腺癌。许多被发现增加接受化疗可能性的临床因素与当前肿瘤学指南一致。在确定的 19 项相关研究中，只有 6 项（32%）报告了专门针对转移性癌症的数据；大多数研究为了分析目的将 I-IV 期的女性合并在一起。
结论
对乳腺癌治疗模式的研究可以帮助确定为特定女性亚组提供的医疗保健方面的挑战，并帮助研究人员在临床和结果研究中设计考虑到这些因素的研究。尽管很少，但仅评估转移性乳腺癌女性的研究表明，影响接受化疗相关决策的因素在这种疾病的各个阶段都是相似的。
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