头颈部癌症患者对国家综合癌症网络治疗后监测指南的依从性。
Adherence with National Comprehensive Cancer Network posttreatment surveillance guidelines in patients with head and neck cancer.
机构信息
Department of Head and Neck Surgery, Division of Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
出版信息
Head Neck. 2019 Nov;41(11):3960-3969. doi: 10.1002/hed.25936. Epub 2019 Sep 9.
BACKGROUND
Surveillance in head and neck cancer (HNC) is essential to detect recurrent or new lesions and to optimize function. This study describes drivers of surveillance adherence in patients with HNC and its effect on prognosis.
METHODS
Adherence with surveillance of HNC patients was determined using the National Comprehensive Cancer Network HNC guidelines. Logistic regression and Cox proportional hazards models were used to determine predictors of adherence and overall survival (OS).
RESULTS
Results showed that 110 of 221 patients (50.2%) were adherent with surveillance. Distance from the treatment center was the only significant association. Adherence was not associated with OS following multivariate adjustment (adjusted hazard ratio [aHR] = 0.68, 95% confidence interval [CI] = 0.43-1.09). However, 5-10 years after treatment completion, adherence was an independent predictor of survival (aHR = 0.24, 95% CI = 0.09-0.61).
CONCLUSION
Adherence with surveillance is important in improving survival in patients with HNC, especially in the long term.
背景
对头颈癌（HNC）进行监测对于发现复发或新病变以及优化功能至关重要。本研究描述了 HNC 患者监测依从性的驱动因素及其对预后的影响。
方法
使用国家综合癌症网络 HNC 指南确定 HNC 患者的监测依从性。使用逻辑回归和 Cox 比例风险模型来确定依从性和总生存（OS）的预测因素。
结果
结果显示，221 名患者中有 110 名（50.2%）符合监测要求。距离治疗中心的距离是唯一具有显著相关性的因素。在多变量调整后，依从性与 OS 无相关性（调整后的危险比[aHR]=0.68，95%置信区间[CI]=0.43-1.09）。然而，在治疗完成后 5-10 年内，依从性是生存的独立预测因素（aHR=0.24，95%CI=0.09-0.61）。
结论
HNC 患者的监测依从性对于提高生存至关重要，尤其是在长期。
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