2005 年至 2015 年期间德国局限性高危前列腺癌男性患者中激素治疗的不充分应用：基于登记数据的分析。

Suboptimal use of hormonal therapy among German men with localized high-risk prostate Cancer during 2005 to 2015: analysis of registry data.

机构信息

Department of Radiation Oncology, Health Services Research Group, University Hospital Halle (Saale), Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.

Department of Radiation Oncology, University Hospital Halle (Saale), Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.

出版信息

BMC Cancer. 2022 Jun 7;22(1):624. doi: 10.1186/s12885-022-09677-z.

DOI:10.1186/s12885-022-09677-z

PMID:35672732

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9171996/

Abstract

BACKGROUND

This study assesses the use of hormonal therapy to treat high-risk localized prostate cancer (HRLPCa) cases diagnosed between 2005 and 2015.

METHODS

All NM with ≥T or PCa cases with poorly differentiated feature (equivalent to Gleason score ≥ 8), diagnosed between 2005 and 2015 were extracted from German population-based cancer registries. Cases treated by surgery or chemotherapy were excluded. Description of hormonal therapy use by HRLPCa cases' profile was presented. Relative risk (RR) was computed with a log-link function to identify factors associated with hormonal therapy use among radiotherapy-treated HRLPCa cases.

RESULTS

A total of 5361 HRLPCa cases were analyzed. Only 27.6% (95% confidence interval [CI]: 26.4-28.8%) of the HRLPCa cases received hormonal therapy in combination with radiotherapy. The use of combined hormonal therapy and radiotherapy varied from 19.8% in Saxony to 47.8% in Schleswig-Holstein. Application of hormonal therapy was higher for the locally advanced cases compared to the poorly differentiated cases (relative risk [RR] = 1.28; 95%CI: 1.19, 1.37). Older patients showed a slightly increased use of hormonal therapy (RR for a 10-year age increase = 1.09; 95%CI: 1.02, 1.16). Compared to PCa cases from the most affluent residential areas, cases from the least affluent (RR = 0.71; 95%CI: 0.55, 0.92) and medium (RR = 0.75; 95%CI: 0.58, 0.96) areas had decreased use of hormonal therapy. The introduction of the German S3-guideline did not make a marked difference in the uptake of both hormonal therapy and radiotherapy (RR = 1.02; 95%CI: 0.95, 1.09).

CONCLUSION

This study found a low use of hormonal therapy among HRLPCa patients treated without surgery. The introduction of the German S3-guideline for prostate cancer treatment does not seem to have impacted hormonal therapy use.

摘要

背景

本研究评估了 2005 年至 2015 年间诊断为高危局限性前列腺癌（HRLPCa）病例的激素治疗应用情况。

方法

从德国基于人群的癌症登记处提取所有 NM 伴≥T 或前列腺癌病例中分化不良特征（相当于 Gleason 评分≥8）的病例。排除接受手术或化疗治疗的病例。描述了 HRLPCa 病例特征中激素治疗的应用情况。使用对数链接函数计算相对风险（RR），以确定接受放疗治疗的 HRLPCa 病例中与激素治疗使用相关的因素。

结果

共分析了 5361 例 HRLPCa 病例。仅 27.6%（95%置信区间[CI]：26.4-28.8%）的 HRLPCa 病例接受了激素治疗联合放疗。在萨克森州，联合激素治疗和放疗的应用率为 19.8%，而在石勒苏益格-荷尔斯泰因州则为 47.8%。与分化不良病例相比，局部晚期病例应用激素治疗的比例更高（相对风险[RR] = 1.28；95%CI：1.19，1.37）。年龄较大的患者使用激素治疗的比例略有增加（每增加 10 岁 RR = 1.09；95%CI：1.02，1.16）。与来自最富裕居住地区的前列腺癌病例相比，来自最贫困（RR = 0.71；95%CI：0.55，0.92）和中等（RR = 0.75；95%CI：0.58，0.96）地区的病例使用激素治疗的比例较低。德国 S3 指南的引入并没有显著改变激素治疗和放疗的应用（RR = 1.02；95%CI：0.95，1.09）。