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在线诊疗对鼻咽癌随访依从性和生存结局的影响:来自流行地区的真实世界队列研究

Effect of Online Clinic on Follow-Up Compliance and Survival Outcomes in Nasopharyngeal Carcinoma: Real-World Cohort Study from Endemic Area.

作者信息

Chen Siqi, Feng Chenyang, Sun Peng, Zhang Jingrong, Liang Hu

机构信息

Lingnan College, Sun Yat-sen University, Guangzhou 510275, China.

Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060, China.

出版信息

Healthcare (Basel). 2024 Jul 21;12(14):1452. doi: 10.3390/healthcare12141452.

Abstract

Nasopharyngeal carcinoma (NPC) requires regular follow-up to detect recurrence as early as possible. However, many patients are unable to regularly follow up due to the inconvenience of the conventional approach. Therefore, this study was designed to investigate the impact of the online clinic on follow-up compliance and prognosis in NPC patients. Patients who were first diagnosed with NPC between April 2019 and November 2019 were enrolled. Good follow-up compliance was defined as having at least one follow-up visit every 6 months within 2 years after treatment completion. Sensitivity analyses were performed using a propensity score matching model. A total of 539 (42%) patients used online follow-up while 731 (58%) used traditional follow-up. The median age of patients in the online cohort was lower than that in the traditional cohort (44 vs. 47, < 0.001). Compared with the traditional cohort, the online cohort had significantly better follow-up compliance (57.3% vs. 17.1%, < 0.001) and a higher 2-year PFS rate (98.1% vs. 94.4%, = 0.003). Survival analysis showed that online follow-up was an independent factor for better survival prognosis (HR 0.39, 95%CI 0.20-0.74, = 0.004). Sensitivity analysis further confirmed these results. Our study found that the online clinic increased follow-up compliance and improved prognosis in NPC patients.

摘要

鼻咽癌(NPC)需要定期随访以便尽早发现复发情况。然而,由于传统随访方式不便,许多患者无法定期进行随访。因此,本研究旨在调查在线门诊对NPC患者随访依从性和预后的影响。纳入了2019年4月至2019年11月期间首次诊断为NPC的患者。良好的随访依从性定义为在治疗完成后的2年内每6个月至少进行一次随访。使用倾向评分匹配模型进行敏感性分析。共有539名(42%)患者采用在线随访,731名(58%)患者采用传统随访。在线队列患者的中位年龄低于传统队列(44岁对47岁,<0.001)。与传统队列相比,在线队列的随访依从性显著更好(57.3%对17.1%,<0.001),2年无进展生存率更高(98.1%对94.4%,=0.003)。生存分析表明,在线随访是生存预后更好的独立因素(HR 0.39,95%CI 0.20 - 0.74,=0.004)。敏感性分析进一步证实了这些结果。我们的研究发现,在线门诊提高了NPC患者的随访依从性并改善了预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c31/11276505/e09e211f2892/healthcare-12-01452-g001.jpg

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