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肺癌患者从首次症状到治疗的历程:来自希腊注册研究的结果。

Lung cancer patients' journey from first symptom to treatment: Results from a Greek registry.

机构信息

ECONCARE LP, Athens, Greece.

Oncology Unit, 3rd Department of Medicine, Athens Medical School, National & Kapodistrian University of Athens, Greece.

出版信息

Cancer Epidemiol. 2019 Jun;60:193-200. doi: 10.1016/j.canep.2019.04.014. Epub 2019 May 4.

Abstract

BACKGROUND

To map the patients' journey from symptoms onset to treatment initiation for the most frequent histological types of lung cancer in Greece and describe the initial treatment that patients receive.

METHODS

The primary data source was a Greek hospital-based registry. Demographic, anthropometric, lifestyle, and diagnostic-related characteristics as well as treatment-related data were extracted from the registry for patients diagnosed with Adenocarcinoma, Squamous and Small Cell Lung Cancer (SCLC). The time intervals from symptoms onset to diagnosis (StD), diagnosis to treatment initiation (DtT), symptoms onset to treatment initiation (StT) and surgery to post-surgery treatment (SRGtT) were estimated.

RESULTS

231, 120 and 122 patients were diagnosed with Adenocarcinoma, SCLC and Squamous, respectively. The percentage of patients diagnosed at stage III/IV ranged from 75% in Adenocarcinoma to 97.5% in SCLC (p < 0.001). The median (IQR) StD was 52 (28-104) days and no difference was detected across the three histological types (p = 0.301). Cough as first symptom was the only determinant of StD (p = 0.001). The median (IQR) DtT was 23 (13-36) days, with this time interval being shorter among patients with SCLC compared to patients with Adenocarcinoma and Squamous (p < 0.001). The median (IQR) StT was 81 (51-139) days. Almost one third of patients with Adenocarcinoma and Squamous were subjected first to surgery and the median (IQR) SRGtT was 42 (34-55) days.

CONCLUSIONS

Our results indicate that time interval from symptoms onset to treatment initiation in Greece is substantially prolonged, highlighting the need for strategies to expedite lung cancer diagnosis and access to evidence-based treatment.

摘要

背景

本研究旨在描绘希腊最常见肺癌组织学类型患者从症状出现到开始治疗的就诊流程,并描述患者接受的初始治疗。

方法

本研究的主要数据来源是一个希腊基于医院的登记处。从登记处提取了患者的人口统计学、人体测量学、生活方式和诊断相关特征以及治疗相关数据,这些患者被诊断为腺癌、鳞状细胞癌和小细胞肺癌(SCLC)。从症状出现到诊断(StD)、诊断到治疗开始(DtT)、症状出现到治疗开始(StT)以及手术到术后治疗(SRGtT)的时间间隔进行了估计。

结果

分别有 231、120 和 122 名患者被诊断为腺癌、SCLC 和鳞状细胞癌。腺癌患者中 75%被诊断为 III/IV 期,而 SCLC 患者中这一比例高达 97.5%(p<0.001)。中位(IQR)StD 为 52(28-104)天,三种组织学类型之间无差异(p=0.301)。以咳嗽为首发症状是 StD 的唯一决定因素(p=0.001)。中位(IQR)DtT 为 23(13-36)天,SCLC 患者的这一时间段短于腺癌和鳞状细胞癌患者(p<0.001)。中位(IQR)StT 为 81(51-139)天。约三分之一的腺癌和鳞状细胞癌患者首先接受了手术,中位(IQR)SRGtT 为 42(34-55)天。

结论

我们的研究结果表明,希腊从症状出现到开始治疗的时间间隔明显延长,这突出表明需要采取策略来加快肺癌的诊断并获得基于证据的治疗。

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