Department of Medicine, Section of Epidemiology and Population Sciences, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA.
The Ohio State University, Columbus, OH, USA.
J Neurooncol. 2021 May;152(3):603-615. doi: 10.1007/s11060-021-03736-4. Epub 2021 Mar 23.
Race/ethnicity have been previously shown to significantly affect survival after diagnosis with glioblastoma, but the cause of this survival difference is not known. The aim of this study was to examine variation in treatment pattern and time to treatment by race/ethnicity, and the extent to which this affects survival.
Data were obtained from the National Cancer Database (NCDB) for adults ≥ 40 with glioblastoma from 2004 to 2016 (N = 68,979). Treatment patterns and time to treatment by race/ethnicity were compared using univariable and multivariable logistic and linear regression models, respectively, and adjusted for known prognostic factors and factors potentially affecting health care access.
Black non-Hispanics (BNH) and Hispanics were less likely to receive radiation and less likely to receive chemotherapy as compared to White non-Hispanics (WNH). Time to radiation initiation was ~ 2 days longer and time to chemotherapy initiation was ~ 4 days longer in both groups in comparison to WNH.
Both race/ethnicity and treatment timing significantly affected survival time, and this association remained after adjustment for known prognostic factors. Additional research is necessary to disentangle the specific causal factors, and the mechanism with which they affect survival.
种族/民族先前已被证明对胶质母细胞瘤诊断后的生存有显著影响，但造成这种生存差异的原因尚不清楚。本研究旨在研究种族/民族之间的治疗模式和治疗时间的差异，并评估其对生存的影响程度。
本研究的数据来自于 2004 年至 2016 年（N = 68979）年龄≥40 岁患有胶质母细胞瘤的成年人的国家癌症数据库（NCDB）。分别采用单变量和多变量逻辑回归模型和线性回归模型比较了种族/民族之间的治疗模式和治疗时间，并根据已知的预后因素和可能影响医疗保健获取的因素进行了调整。
与白人非西班牙裔（WNH）相比，黑人非西班牙裔（BNH）和西班牙裔接受放疗和化疗的可能性较低。与 WNH 相比，两组患者的放疗开始时间延迟了约 2 天，化疗开始时间延迟了约 4 天。
种族/民族和治疗时机都显著影响了生存时间，并且在调整了已知的预后因素后，这种关联仍然存在。需要进一步研究以阐明具体的因果因素及其影响生存的机制。
