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胶质母细胞瘤治疗的距离:衡量社会经济地位对生存的影响的一个指标。

Distance traveled to glioblastoma treatment: A measure of the impact of socioeconomic status on survival.

机构信息

Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA.

Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA.

出版信息

Clin Neurol Neurosurg. 2021 Oct;209:106909. doi: 10.1016/j.clineuro.2021.106909. Epub 2021 Aug 28.

Abstract

BACKGROUND

Previous studies have shown improved post-surgical outcomes in patients who travel farther for glioblastoma treatment. This study investigates socioeconomic and facility factors that may influence this relationship.

METHODS

Overall survival was calculated and compared by distance to treatment facility using univariate and multivariate survival models. The analysis was stratified by facility type, income quartile and insurance status and the association re-evaluated. Kaplan-Meier survival curves were created to analyze the relationship between overall survival and distance group.

RESULTS

Individuals who traveled less than 5 miles to treatment had the shortest overall survival (11.8 months), while those who traveled greater than 50 miles had the longest survival (12.9 months). Stratification by income quartile failed to demonstrate an association between distance traveled and survival for those making less than $63,000 (adjusted hazard ratio range: 0.94-1.01). There was no association between survival and distance traveled for patients treated at a community cancer center, comprehensive community cancer center or an integrated network cancer program (adjusted hazard ratio range: 0.86-1.04).

CONCLUSION

Financial strain, rather than distance traveled to treatment, may be associated with glioblastoma survival.

摘要

背景

先前的研究表明,为胶质母细胞瘤治疗而长途跋涉的患者术后效果有所改善。本研究调查了可能影响这种关系的社会经济和医疗机构因素。

方法

使用单变量和多变量生存模型,根据到治疗机构的距离计算并比较总生存率。该分析按机构类型、收入四分位数和保险状况进行分层,并重新评估关联。绘制 Kaplan-Meier 生存曲线,以分析总生存率与距离组之间的关系。

结果

到治疗机构的距离小于 5 英里的患者总生存率最短(11.8 个月),而距离大于 50 英里的患者生存率最长(12.9 个月)。按收入四分位数分层,对于收入低于 63,000 美元的患者,旅行距离与生存之间没有关联(调整后的危险比范围:0.94-1.01)。对于在社区癌症中心、综合社区癌症中心或综合网络癌症计划治疗的患者,生存与旅行距离之间没有关联(调整后的危险比范围:0.86-1.04)。

结论

可能与胶质母细胞瘤患者的生存相关的是经济压力,而不是到治疗机构的旅行距离。

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