Department of Public Health, University of North Florida, Jacksonville, FL, USA.
Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
BMC Cancer. 2022 Aug 1;22(1):837. doi: 10.1186/s12885-022-09946-x.
Despite benefits of endocrine therapy (ET) for patients with hormone-receptor (HR)-positive breast cancer, many patients do not initiate or discontinue ET against recommendations.
We identified variables associated with ET initiation and continuation, analyzing pooled data from two longitudinal studies at a National Cancer Institute comprehensive cancer center in St. Louis, Missouri. The sample included 533 women with newly diagnosed, non-metastatic, HR-positive breast cancer who completed interviews at enrollment and 6, 12, and 24 months after definitive surgical treatment. Logistic regression models estimated the adjusted odds ratio and 95% confidence interval (aOR [95% CI]) for each of self-reported ET initiation by the 12-month interview and continuation for ≥12 months by the 24-month interview in association with self-reported diabetes, elevated depressed mood, menopausal-symptom severity and obesity, adjusting for race, age, insurance status, chemotherapy, and radiation therapy.
Overall, 81.4% (434/533) of patients initiated ET, and 86.5% (371/429) continued ET ≥12 months. Patients with diabetes had lower odds of initiating ET (0.50 [0.27-0.91]). Patients reporting greater menopausal-symptom severity had lower odds of continuing ET (0.72 [0.53-0.99]).
Efforts to increase ET initiation among patients with diabetes and better manage severe menopausal symptoms among ET users might promote ET continuation.
ClinicalTrials.gov : #NCT00929084.
尽管激素受体（HR）阳性乳腺癌患者接受内分泌治疗（ET）有获益，但许多患者并未按照建议开始或停止 ET。
我们鉴定了与 ET 起始和持续相关的变量，对密苏里州圣路易斯市国立癌症研究所综合癌症中心的两项纵向研究进行了汇总数据分析。该样本包括 533 名新诊断、非转移性、HR 阳性乳腺癌患者，他们在入组时以及在确定性手术治疗后 6、12 和 24 个月完成了访谈。逻辑回归模型估计了自报 ET 起始的调整比值比和 95%置信区间（aOR [95%CI]），以 12 个月访谈时自报开始 ET 以及 24 个月访谈时报告至少持续 12 个月为结局，与自报糖尿病、抑郁情绪升高、绝经症状严重程度和肥胖相关，调整了种族、年龄、保险状况、化疗和放疗。
总体而言，81.4%（434/533）的患者开始 ET，86.5%（371/429）的患者持续 ET≥12 个月。患有糖尿病的患者开始 ET 的可能性较低（0.50 [0.27-0.91]）。报告绝经症状更严重的患者持续 ET 的可能性较低（0.72 [0.53-0.99]）。
努力提高糖尿病患者开始 ET 的比例，并更好地管理 ET 使用者的严重绝经症状，可能会促进 ET 的持续使用。
ClinicalTrials.gov：#NCT00929084。
