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中国乳腺癌患者内分泌治疗的依从性:现状与改进建议

Adherence to endocrine therapy among Chinese patients with breast cancer: current status and recommendations for improvement.

作者信息

Gao Pin, You Lili, Wu Di, Shi Aiping, Miao Qing, Rana Ujala, Martin Dustin Paul, Du Ye, Zhao Gang, Han Bing, Zheng Chao, Fan Zhimin

机构信息

Department of Breast Surgery, First Hospital of Jilin University, Changchun, Jilin, China.

Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.

出版信息

Patient Prefer Adherence. 2018 May 22;12:887-897. doi: 10.2147/PPA.S167004. eCollection 2018.

Abstract

BACKGROUND

Postoperative endocrine therapy is known to reduce recurrence and mortality in patients with estrogen receptor (ER)- or progestogen receptor (PR)-positive breast cancer. Correlates and determinants of compliance with endocrine therapy among Chinese patients with breast cancer are not known. The aim of this study was to elucidate the efficacy and adherence of endocrine therapy in China and suggest effective improvements on the adherence.

PATIENTS AND METHODS

We analyzed the survival of 1,110 patients eligible for endocrine therapy and adherence of 699 patients to endocrine therapy. Kaplan-Meier curves, log-rank tests and Cox proportional hazard models were used to evaluate survival, and logistic regression models were used to assess variables associated with treatment adherence.

RESULTS

Long-term endocrine therapy was associated with lower recurrence rate (HR 0.72; 95% CI 0.56-0.93; =0.013). Adherence to endocrine therapy was only 63.1%. Sociodemographic characteristics of patients, clinical- and medication-related characteristics and patients' attitudes were associated with adherence to endocrine therapy.

CONCLUSION

Adherence to endocrine therapy in Chinese patients with ER+/PR+ breast cancer was <65%. Both patients and physicians should take progressive steps to improve the rate of adherence.

摘要

背景

已知术后内分泌治疗可降低雌激素受体(ER)或孕激素受体(PR)阳性乳腺癌患者的复发率和死亡率。中国乳腺癌患者内分泌治疗依从性的相关因素和决定因素尚不清楚。本研究的目的是阐明中国内分泌治疗的疗效和依从性,并提出提高依从性的有效改进措施。

患者与方法

我们分析了1110例适合内分泌治疗患者的生存情况以及699例患者内分泌治疗的依从性。采用Kaplan-Meier曲线、对数秩检验和Cox比例风险模型评估生存情况,采用逻辑回归模型评估与治疗依从性相关的变量。

结果

长期内分泌治疗与较低的复发率相关(风险比0.72;95%置信区间0.56 - 0.93;P = 0.013)。内分泌治疗的依从性仅为63.1%。患者的社会人口学特征、临床和用药相关特征以及患者态度与内分泌治疗依从性相关。

结论

中国ER+/PR+乳腺癌患者内分泌治疗的依从性低于65%。患者和医生都应采取积极措施提高依从率。

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