Efird Jimmy T, Hunter Sharyn, Chan Sally, Jeong Sarah, Thomas Susan L, Jindal Charulata, Biswas Tithi
Centre for Clinical Epidemiology and Biostatistics (CCEB), School of Medicine and Public Health, The University of Newcastle (UoN), Newcastle 2308, Australia.
Priority Research Centre for Generational Health and Ageing (PRCGHA), School of Medicine and Public Health, the University of Newcastle (UoN), Newcastle 2308, Australia.
Medicines (Basel). 2018 Jun 25;5(3):62. doi: 10.3390/medicines5030062.
Radiotherapy (RT) plays an important role in the management and survival of patients with breast cancer. The aim of this study was to examine the association between age, comorbidities and use of RT in this population. Patients diagnosed with breast cancer from 2004⁻2013 were identified from the American College of Surgeons National Cancer Database (NCDB). Follow-up time was measured from the date of diagnosis (baseline) to the date of death or censoring. Adjusted hazard ratios (aHR) and 95% confidence intervals (95% CI) were used as the measure of association. Independently of comorbidities and other important outcome-related factors, patients >65 years of age who received RT survived significantly longer than those who did not receive RT (aHR = 0.53, 95% CI = 0.52⁻0.54). However, as women aged, those with comorbidities were less likely to receive RT (adjusted -trend by age < 0.0001). The development of decision-making tools to assist clinicians, and older women with breast cancer and comorbidities, are needed to facilitate personalized treatment plans regarding RT. This is particularly relevant as the population ages and the number of women with breast cancer is expected to increase in the near future.
放射治疗（RT）在乳腺癌患者的治疗和生存中起着重要作用。本研究的目的是探讨该人群中年龄、合并症与放射治疗使用之间的关联。从美国外科医师学会国家癌症数据库（NCDB）中确定了2004年至2013年期间诊断为乳腺癌的患者。随访时间从诊断日期（基线）测量至死亡或截尾日期。调整后的风险比（aHR）和95%置信区间（95%CI）用作关联度量。与合并症和其他重要的预后相关因素无关，接受放疗的65岁以上患者的生存期明显长于未接受放疗的患者（aHR = 0.53，95%CI = 0.52 - 0.54）。然而，随着女性年龄的增长，患有合并症的女性接受放疗的可能性较小（按年龄调整的趋势<0.0001）。需要开发决策工具来帮助临床医生以及患有乳腺癌和合并症的老年女性，以促进关于放疗的个性化治疗方案。随着人口老龄化以及预计在不久的将来乳腺癌女性数量会增加，这一点尤为重要。
