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巴西老年肺癌患者的治疗不足趋势。

Undertreatment trend in elderly lung cancer patients in Brazil.

作者信息

Costa Guilherme Jorge, de Mello Maria Júlia Gonçalves, Ferreira Carlos Gil, Thuler Luiz Claudio Santos

机构信息

Department of Oncology, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco, Brazil.

Hospital Infection Control Committee, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco, Brazil.

出版信息

J Cancer Res Clin Oncol. 2017 Aug;143(8):1469-1475. doi: 10.1007/s00432-017-2412-8. Epub 2017 Apr 7.

Abstract

PURPOSE

Elderly patients with lung cancer tend to be undertreated in comparison to younger patients. The objective of this study is to compare treatment modalities offered to lung cancer patients from 70 years of age or more with patients under 70.

METHODS

For this study, an analytical cross-sectional epidemiological study conducted with data from the Brazilian hospital-based cancer registries between the years 2000 and 2011. In addition, odds ratios (OR) were calculated, with a 95% confidence intervals (95% CI), in conjunction with the construction of a logistic regression model.

RESULTS

By analyzing the records of 40,403 patients with lung cancer, we found that overall, patients from 70 years of age or more corresponded to 28.6% of the study population. Squamous cell carcinoma was the most common histological type among patients ≥70 years of age, whereas adenocarcinoma was the more prevalent type among younger patients. In comparison to younger patients, the older ones were treated less often (OR = 0.57; 95% CI: 0.52-0.62). Moreover, older patients were less likely to undergo surgery (OR = 0.69; 95% CI: 0.64-0.75), radiotherapy (OR = 0.86; 95% CI: 0.81-0.92), chemotherapy (OR = 0.61; 95% CI: 0.57-0.64), or an association of two or more treatment modalities (OR = 0.58; 95% CI: 0.54-0.62).

CONCLUSION

The study finds that Brazilian lung cancer patients ≥70 years of age are often undertreated and higher percentage of early death rates as compared to patients under 70. In regard to treatment, age alone should not determine whether patients with lung cancer are treated or not.

摘要

目的

与年轻患者相比,老年肺癌患者往往治疗不足。本研究的目的是比较70岁及以上肺癌患者与70岁以下患者所接受的治疗方式。

方法

本研究采用分析性横断面流行病学研究方法,使用2000年至2011年巴西医院癌症登记处的数据。此外,计算比值比(OR)及其95%置信区间(95%CI),并构建逻辑回归模型。

结果

通过分析40403例肺癌患者的记录,我们发现总体而言,70岁及以上患者占研究人群的28.6%。鳞状细胞癌是70岁及以上患者中最常见的组织学类型,而腺癌在年轻患者中更为普遍。与年轻患者相比,老年患者接受治疗的频率较低(OR = 0.57;95%CI:0.52 - 0.62)。此外,老年患者接受手术(OR = 0.69;95%CI:0.64 - 0.75)、放疗(OR = 0.86;95%CI:0.81 - 0.92)、化疗(OR = 0.61;95%CI:0.57 - 0.64)或两种或更多种治疗方式联合治疗(OR = 0.58;95%CI:0.54 - 0.62)的可能性较小。

结论

该研究发现,与70岁以下患者相比,巴西70岁及以上肺癌患者往往治疗不足,且早期死亡率较高。在治疗方面,不应仅以年龄来决定肺癌患者是否接受治疗。

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