Sanford Stacy D, Beaumont Jennifer L, Snyder Mallory A, Reichek Jennifer, Salsman John M
Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
Robert H. Lurie Comprehensive Cancer Center of Northwestern University, 675 N. St. Clair Street Suite 21-100, Chicago, IL, 60611, USA.
Support Care Cancer. 2017 May;25(5):1579-1586. doi: 10.1007/s00520-016-3558-7. Epub 2017 Jan 10.
Minimal clinical trial participation among adolescents and young adults (AYAs) with cancer limits scientific progress and ultimately their clinical care and outcomes. These analyses examine the current state of AYA clinical research participation at a Midwestern comprehensive cancer center and affiliated pediatric hospital to advise program development and increase availability of trials and AYA participation. Enrollment is examined across all diagnoses, the entire AYA age spectrum (15-39), and both cancer therapeutic and supportive care protocols.
his study was a retrospective review of electronic medical records via existing databases and registries for all AYAs. Data were collected for AYAs seen by an oncologist at the adult outpatient cancer center or at the pediatric hospital between the years 2010 and 2014. Descriptive statistics and logistic regression analyses were conducted to characterize this sample.
In the pediatric setting, 42.3% of AYAs were enrolled in a study compared to 11.2% in the adult setting. Regression analyses in the pediatric setting revealed that AYAs with private insurance or Caucasian race were more likely to participate. Within the adult setting, ethnicity, race, insurance, and diagnosis were associated with study participation; 54.8% of study enrollments were for cancer therapeutic and 43.4% for supportive care studies.
These results are comparable to previously published data and support the need for new local and national AYA initiatives to increase the availability of and enrollment in therapeutic clinical trials. The same is true for supportive care studies which play a crucial role in improving quality of life.
癌症青少年及青年成人（AYA）参与临床试验的比例极低，这限制了科学进步，最终也影响了他们的临床护理和治疗结果。这些分析研究了一家中西部综合癌症中心及附属儿科医院中AYA临床研究参与的现状，为项目开发提供建议，并增加试验的可及性以及AYA的参与度。研究考察了所有诊断类型、整个AYA年龄范围（15 - 39岁）以及癌症治疗和支持性护理方案的入组情况。
本研究通过现有数据库和登记处对所有AYA的电子病历进行回顾性分析。收集了2010年至2014年间在成人门诊癌症中心或儿科医院由肿瘤学家诊治的AYA的数据。进行了描述性统计和逻辑回归分析以描述该样本特征。
在儿科环境中，42.3%的AYA参与了研究，而成人环境中的这一比例为11.2%。儿科环境中的回归分析显示，拥有私人保险或白人种族的AYA更有可能参与。在成人环境中，种族、民族、保险和诊断与研究参与相关；54.8%的研究入组是针对癌症治疗，43.4%是针对支持性护理研究。
这些结果与先前发表的数据相当，支持需要开展新的地方和全国性AYA倡议，以增加治疗性临床试验的可及性和入组率。支持性护理研究对于改善生活质量起着关键作用，情况也是如此。
