一家三级医院非转移性乳腺癌治疗的延迟程度：2012年至2018年的分析
The Magnitude of Delay in Non-metastatic Breast Cancer Treatment in a Tertiary Hospital: an Analysis from 2012 to 2018.
作者信息
Velasco Rogelio N, Ando Mark M, Javelosa Mark Anthony U, King Rich Ericson C, Mondragon Karen Anjela M, Tan Harold Nathan C, Ngelangel Corazon A, Real Irisyl O
机构信息
Division of Medical Oncology, Department of Medicine, Philippine General Hospital, University of the Philippines Manila.
Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila.
出版信息
Acta Med Philipp. 2025 Jun 30;59(8):45-51. doi: 10.47895/amp.vi0.9028. eCollection 2025.
BACKGROUND AND OBJECTIVE
The burden of treatment delay in breast cancer is high, especially among developing countries. Despite adversely affecting morbidity and mortality, treatment delay remains unexplored in the Philippines. This study aimed to determine treatment delays among breast cancer patients in a tertiary hospital during surgery, neoadjuvant chemotherapy, and adjuvant chemotherapy, and to identify predictors of delay.
METHODS
A cross-sectional study was conducted among breast cancer patients seen between January 1, 2012 to December 31, 2018. The following outcomes were investigated: ≥90 days from initial diagnosis to surgery, ≥8 weeks from diagnosis to initiation of neoadjuvant chemotherapy, and >120 days from diagnosis to initiation of adjuvant chemotherapy. Summary statistics were reported as percent for categorical data and as mean for continuous data. The individual correlations were performed using Chi-square for qualitative data and t-test for quantitative data while predictors were determined through logistic regression.
RESULTS
A total of 324 patients were included in this study. The majority of the patients were less than 65 years old living in urban areas. More than half of the patients were overweight or obese, hypertensive, and diabetic. The following delays were observed: 61.1% (n = 198) with any type of delay, 23.8% (n = 53) with delay in surgery, 53.8% (n = 120) with delay in adjuvant chemotherapy, and 74.3% (n = 75) with delay in neoadjuvant chemotherapy. The patients noted to have any type of delay were more likely to be hypertensive (p = 0.046) and residing in urban areas (p = 0.041). There were no differences in the distribution of age, body mass index, and presence of co-morbid conditions such as hypertension, diabetes mellitus, coronary artery disease, and heart failure among those with any form of delay compared with no delay.
CONCLUSIONS
The present study shows the presence of treatment delay among breast cancer patients and may be used to enact policy changes to optimize breast cancer care delivery. Further studies may be done to identify other factors affecting these delays and policy changes are recommended to address these gaps in surgery and chemotherapy administration among breast cancer patients.
背景与目的
乳腺癌治疗延迟的负担很重，尤其是在发展中国家。尽管治疗延迟对发病率和死亡率有不利影响，但在菲律宾，治疗延迟问题仍未得到研究。本研究旨在确定三级医院乳腺癌患者在手术、新辅助化疗和辅助化疗期间的治疗延迟情况，并找出延迟的预测因素。
方法
对2012年1月1日至2018年12月31日期间就诊的乳腺癌患者进行了一项横断面研究。调查了以下结果：从初次诊断到手术≥90天、从诊断到开始新辅助化疗≥8周、从诊断到开始辅助化疗>120天。分类数据的汇总统计以百分比表示，连续数据以均值表示。定性数据使用卡方检验，定量数据使用t检验进行个体相关性分析，通过逻辑回归确定预测因素。
结果
本研究共纳入324例患者。大多数患者年龄小于65岁，居住在城市地区。超过一半的患者超重或肥胖、患有高血压和糖尿病。观察到以下延迟情况：61.1%（n = 198）存在任何类型的延迟，23.8%（n = 53）手术延迟，53.8%（n = 120）辅助化疗延迟，74.3%（n = 75）新辅助化疗延迟。被指出有任何类型延迟的患者更有可能患有高血压（p = 0.046）且居住在城市地区（p = 0.041）。与无延迟的患者相比，有任何形式延迟的患者在年龄、体重指数以及高血压、糖尿病、冠状动脉疾病和心力衰竭等合并症的分布方面没有差异。
结论
本研究表明乳腺癌患者存在治疗延迟情况，可用于制定政策变革以优化乳腺癌护理服务。建议进一步开展研究以确定影响这些延迟的其他因素，并建议进行政策变革以解决乳腺癌患者手术和化疗管理方面的这些差距。
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