Department of Hematology and Oncology, TheUniversity of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Oncologist. 2012;17(3):303-11. doi: 10.1634/theoncologist.2011-0316. Epub 2012 Feb 27.
Rates of anthracycline adherence in breast cancer (BC) patients are unknown, but noncompletion of chemotherapy is associated with worse outcomes.
Using the Surveillance, Epidemiology, and End Results-Medicare database, we obtained demographics, comorbidities, tumor characteristics, and treatment and hospitalization data from stage I-III BC patients diagnosed at age ≥66 years in 1996-2005 treated with surgery who had anthracycline claims. We compared variables between patients with claims for less than four cycles, considered nonadherent cases, and those with claims for four or more cycles using logistic regression analyses.
The sample included 7,399 patients, of whom 1,222 (16.5%) were nonadherent cases. Two hundred forty-three (3.3%) patients had one claim, 298 (4.0%) had two claims, and 681 (9.2%) had three claims. The multivariate regression model showed statistically significant associations between nonadherence and older age, black race, unmarried status, diagnosis before the year 2001, and hospitalizations.
Eighty-three percent of older patients with early-stage BC completed at least four cycles of an anthracycline-based chemotherapy regimen. We identified a subset of patients with a higher likelihood of not adhering to the course of treatment. Further research is warranted to develop interventions to enhance adherence.
乳腺癌（BC）患者接受蒽环类药物治疗的比例尚不清楚，但化疗不完成与预后较差有关。
我们使用监测、流行病学和最终结果-医疗保险数据库，从 1996 年至 2005 年期间年龄≥66 岁接受手术治疗且有蒽环类药物治疗记录的 I-III 期 BC 患者中获取了人口统计学、合并症、肿瘤特征以及治疗和住院数据。我们使用逻辑回归分析比较了少于四个疗程（被认为是不依从病例）和四个或更多疗程的患者之间的变量。
该样本包括 7399 名患者，其中 1222 名（16.5%）是不依从病例。243 名（3.3%）患者有一个疗程记录，298 名（4.0%）有两个疗程记录，681 名（9.2%）有三个疗程记录。多变量回归模型显示，不依从与年龄较大、黑人种族、未婚状态、2001 年前诊断以及住院治疗之间存在统计学显著关联。
83%的早期 BC 老年患者至少完成了四个疗程的蒽环类药物化疗方案。我们确定了一组更有可能不遵守治疗方案的患者。需要进一步研究以制定干预措施来提高依从性。
