Division of Radiation Oncology, University of Alberta, Edmonton, AB, Canada.
World J Surg Oncol. 2012 Jun 26;10:118. doi: 10.1186/1477-7819-10-118.
To analyze the characteristics and outcomes of women with breast cancer in the Northern Alberta Health Region (NAHR) who declined recommended primary standard treatments.
A chart review was performed of breast cancer patients who refused recommended treatments during the period 1980 to 2006. A matched pair analysis was performed to compare the survival data between those who refused or received standard treatments.
A total of 185 (1.2%) patients refused standard treatment. Eighty-seven (47%) were below the age of 75 at diagnosis. The majority of those who refused standard treatments were married (50.6%), 50 years or older (60.9%), and from the urban area (65.5%). The 5-year overall survival rates were 43.2% (95% CI: 32.0 to 54.4%) for those who refused standard treatments and 81.9% (95% CI: 76.9 to 86.9%) for those who received them. The corresponding values for the disease-specific survival were 46.2% (95% CI: 34.9 to 57.6%) vs. 84.7% (95% CI: 80.0 to 89.4%).
Women who declined primary standard treatment had significantly worse survival than those who received standard treatments. There is no evidence to support using Complementary and Alternative Medicine (CAM) as primary cancer treatment.
分析在艾伯塔省北部卫生区域（NAHR）拒绝推荐的主要标准治疗的乳腺癌女性的特征和结局。
对 1980 年至 2006 年间拒绝推荐治疗的乳腺癌患者进行了病历回顾。对拒绝或接受标准治疗的患者进行了匹配对分析，以比较生存数据。
共有 185 名（1.2%）患者拒绝标准治疗。87 名（47%）患者在诊断时年龄低于 75 岁。拒绝标准治疗的大多数患者已婚（50.6%），年龄在 50 岁或以上（60.9%），来自城市地区（65.5%）。拒绝标准治疗的患者 5 年总生存率为 43.2%（95%CI：32.0 至 54.4%），而接受标准治疗的患者为 81.9%（95%CI：76.9 至 86.9%）。相应的疾病特异性生存率为 46.2%（95%CI：34.9 至 57.6%）和 84.7%（95%CI：80.0 至 89.4%）。
拒绝主要标准治疗的女性与接受标准治疗的女性相比，生存情况明显较差。没有证据支持使用补充和替代医学（CAM）作为主要癌症治疗方法。
