Berger D, Braverman A, Sohn C K, Morrow M
Department of Surgery, State University of New York Health Science Center, Brooklyn.
Cancer. 1988 Apr 1;61(7):1453-6. doi: 10.1002/1097-0142(19880401)61:7<1453::aid-cncr2820610729>3.0.co;2-#.
This study of compliance was performed to determine whether a medically indigent population with breast carcinoma that has been neglected is an appropriate group for inclusion in an aggressive combined treatment program. After incisional biopsy, 28 locally advanced breast cancer (LABC) patients received two cycles of cytoxan, Adriamycin, 5-Fluorouracil, and tamoxifen (CAFT) followed by a simple mastectomy and level I axillary dissection. After surgery, patients received four additional cycles of CAFT alternating with three cycles of 15 Gy to the chest wall and regional lymphatics. Compliance was defined as overall compliance, the percentage of patients completing the protocol as described; and appointment compliance, the ratio between treatments or appointments attended versus those scheduled. Overall compliance was 75% (21 of 28 patients). The total number of appointments scheduled was 1054 (mean, 37 +/- 2), and the total attended was 965 (mean, 34 +/- 3), giving an appointment compliance rate of 91.7%. Compliance did not vary significantly with age, marital status, nationality, the presence of complications, or delay to diagnosis. Compliance did decrease significantly with time. There was 100% overall compliance at 2 months, 82% at 6 months, and 75% at 1 year. We conclude that although our patients had neglected their disease and were medically indigent, they were highly motivated patients once in therapy. This suggests that complex treatment regimens are feasible as well as effective for the treatment of LABC.
开展这项关于依从性的研究，旨在确定被忽视的患有乳腺癌的医疗贫困人群是否适合纳入积极的联合治疗方案。在进行切开活检后，28例局部晚期乳腺癌（LABC）患者接受了两个周期的环磷酰胺、阿霉素、5-氟尿嘧啶和他莫昔芬（CAFT）治疗，随后进行了单纯乳房切除术和I级腋窝淋巴结清扫术。术后，患者接受了另外四个周期的CAFT治疗，并与对胸壁和区域淋巴结进行三个周期的15 Gy放疗交替进行。依从性被定义为总体依从性，即按所述完成方案的患者百分比；以及预约依从性，即实际接受治疗或预约的次数与预定次数的比率。总体依从性为75%（28例患者中的21例）。预定的预约总数为1054次（平均，37±2次），实际参加的总数为965次（平均，34±3次），预约依从率为91.7%。依从性在年龄、婚姻状况、国籍、是否存在并发症或诊断延迟方面没有显著差异。依从性确实随时间显著下降。2个月时总体依从性为100%，6个月时为82%，1年时为75%。我们得出结论，尽管我们的患者忽视了他们的疾病且医疗贫困，但一旦接受治疗，他们积极性很高。这表明复杂的治疗方案对于LABC的治疗既可行又有效。
