He Yutong, Yu Xue Qin, Luo Qingwei, Xu Xiaoli, Wang Yudong, Li Shumei, Shan Baoen
Hebei Cancer Institute, Hebei Medical University Fourth Hospital, Hebei Province, China.
Cancer Research Division, Cancer Council New South Wales; Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
J Cancer Res Ther. 2018 Jun;14(Supplement):S410-S415. doi: 10.4103/0973-1482.179076.
We reported the patterns of care for a cohort of Chinese patients with nonsmall cell lung cancer (NSCLC) and examined the characteristics of those patients who did not receive cancer-specific treatment.
This was a prospective cohort study. The study population was patients with first primary NSCLC diagnosed and admitted to Hebei Cancer Hospital in Hebei Province in China from January 2004 to December 2005. Logistic regression was used to examine factors associated with no cancer-specific treatment. Cox proportional hazard regression was used to examine the effects of cancer treatment on survival.
Of 579 NSCLC patients included in the study, 73.4% were male, 84.3% died by the end of the study after 7 years follow-up, 40.1% were diagnosed at a late stage of disease, and 33.7% had unknown disease stage. Over half (50.8%) of the patients received palliative care, 23.8% for curative care, and 25.4% did not receive any cancer-specific treatment. The probability of not receiving cancer-specific treatment was significantly higher for those who diagnosed at older age (odds ratio [OR] =3.01, 95% confidence interval [95% CI]: 1.79-5.06), had unknown stage at diagnosis (OR = 2.77, 95% CI: 1.41-5.47), or had unclassified histological type (OR = 3.48, 95% CI: 1.94-6.21). After adjusted for other factors, patients received anti-cancer treatment had significantly lower risk of dying from NSCLC P < 0.0001) compared with patients who did not receive any cancer-specific treatment.
Despite the benefits of anti-cancer treatments confirmed in this study, over a quarter patients did not receive any such treatment. Finding the reasons for the patients who did not receive cancer-specific treatment may improve the quality of patient care in this population.
我们报告了一组中国非小细胞肺癌（NSCLC）患者的治疗模式，并研究了那些未接受癌症特异性治疗的患者的特征。
这是一项前瞻性队列研究。研究人群为2004年1月至2005年12月在中国河北省河北医科大学第四医院确诊并收治的原发性NSCLC患者。采用逻辑回归分析与未接受癌症特异性治疗相关的因素。采用Cox比例风险回归分析癌症治疗对生存的影响。
纳入研究的579例NSCLC患者中，73.4%为男性，84.3%在7年随访结束时死亡，40.1%在疾病晚期确诊，33.7%疾病分期不明。超过一半（50.8%）的患者接受了姑息治疗，23.8%接受了根治性治疗，25.4%未接受任何癌症特异性治疗。年龄较大（优势比[OR]=3.01，95%置信区间[95%CI]：1.79-5.06）、确诊时分期不明（OR=2.77，95%CI：1.41-5.47）或组织学类型未分类（OR=3.48，95%CI：1.94-6.21）的患者未接受癌症特异性治疗的概率显著更高。在调整其他因素后，接受抗癌治疗的患者与未接受任何癌症特异性治疗的患者相比死于NSCLC的风险显著降低（P<0.0001）。
尽管本研究证实了抗癌治疗的益处，但超过四分之一的患者未接受任何此类治疗。找出未接受癌症特异性治疗的患者的原因可能会改善该人群的患者护理质量。
