种族相关的临床试验参与与现代高危前列腺癌患者治疗结局改善的关联。
Race-dependent association of clinical trial participation with improved outcomes for high-risk prostate cancer patients treated in the modern era.
机构信息
Department of Radiation Oncology, University of California, Los Angeles, CA, USA.
Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA.
出版信息
Prostate Cancer Prostatic Dis. 2023 Sep;26(3):625-627. doi: 10.1038/s41391-023-00663-5. Epub 2023 Mar 25.
It is unclear whether cancer patients enrolled in clinical trials have improved outcomes compared with non-study patients. We compared prostate cancer-specific mortality (PCSM) in patients in a real-world setting (SEER-Medicare database) versus on a trial (NRG/RTOG 0521). The 7-year freedom from PCSM was superior in trial patients (92.4% vs. 88.1%, sHR = 1.77 [95% CI 1.05-2.97], P = 0.03). Black trial patients had significantly superior freedom from PCSM than Black real-world patients (sHR 6.52, 95% CI 1.43-29.72, P = 0.02), which was not seen among non-Black patients. Trial patients may have improved outcomes, and racial disparities are accentuated in the real world.
尚不清楚参加临床试验的癌症患者是否比非研究患者的结局更好。我们比较了真实环境下（SEER-医疗保险数据库）与临床试验（NRG/RTOG 0521）中前列腺癌特异性死亡率（PCSM）。试验组患者 7 年无 PCSM 生存率更高（92.4% vs. 88.1%，sHR=1.77[95%CI 1.05-2.97]，P=0.03）。与真实世界的黑人患者相比，黑人试验组患者无 PCSM 生存率显著更高（sHR 6.52，95%CI 1.43-29.72，P=0.02），而非黑人患者中则未观察到这种情况。试验组患者的结局可能更好，而在真实世界中，种族差异更加明显。
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