Cathcart C S, Dunican A, Halpern J N
Department of Radiology, UMDNJ-New Jersey Medical School, University Hospital, Newark 07103, USA.
J Med. 1997;28(5-6):275-84.
A retrospective analysis of survival rate of patients treated for head and neck cancers in a radiation oncology department at an innercity hospital (UMDNJ, Newark, NJ) was performed. Eligible patients received either postoperative or definitive radiation therapy and had no distant metastases. The records of patients treated from 1984-1989 were screened and 78 met the above criteria. Total dose of radiation, fraction size, number of fractions given, and overall duration of treatment were determined. Tumor registry data was used to evaluate patient status. Two patients who died prior to completing radiation treatments were excluded and seven patients were lost to follow up. Therefore, the outcomes and treatments of 69 patients were analyzed. There were two categories of noncompliant patients, those whose treatment duration was in excess of 20% of the prescription, and those whose treatments were discontinued against medical advice. The overall five year survival of the compliant group was 38%, and 12% for the noncompliant group (p < 0.05). The mean survival time for the compliant group was 24.2 months and 12.6 months for the noncompliant group (p < 0.05). Forty-seven per cent of the patients were compliant. Compliant rates for men and women were 46% and 48%, respectively. African-Americans, who made up 71% of the patients analyzed, had a compliance rate of 45%. Caucasians, who made up 22%, had a compliance rate of 47%. The stage at presentation, and therefore prognosis, did not alter compliance rates. Sixty-nine per cent of the patients analyzed had stage III or stage IV disease. This patient group had a compliance rate of 48%, which did not statistically differ from the earlier stage patient group which had a compliance rate of 54%. The length of patient survival from head and neck cancer is related to compliance to radiation treatment. Compliance appears to be directly related to better overall survival and mean survival time. Compliance to treatment does not seem to depend on patient sex, race, or prognosis.
对一家市中心医院（新泽西州纽瓦克市UMDNJ）放射肿瘤学部门治疗的头颈癌患者的生存率进行了回顾性分析。符合条件的患者接受了术后放疗或根治性放疗，且无远处转移。筛查了1984年至1989年期间接受治疗的患者记录，78例符合上述标准。确定了放射总剂量、分次剂量、分次次数以及总治疗持续时间。利用肿瘤登记数据评估患者状况。排除了两名在完成放疗前死亡的患者，7名患者失访。因此，对69例患者的治疗结果和治疗情况进行了分析。有两类不依从患者，一类是治疗持续时间超过处方规定的20%，另一类是违背医嘱中断治疗。依从组的总体五年生存率为38%，不依从组为12%（p<0.05）。依从组的平均生存时间为24.2个月，不依从组为12.6个月（p<0.05）。47%的患者依从。男性和女性的依从率分别为46%和48%。占分析患者71%的非裔美国人的依从率为45%。占22%的白种人的依从率为47%。就诊时的分期以及预后并未改变依从率。分析的患者中有69%患有III期或IV期疾病。该患者组的依从率为48%，与依从率为54%的早期患者组在统计学上无差异。头颈癌患者的生存时长与放疗依从性相关。依从性似乎与更好的总体生存率和平均生存时间直接相关。治疗依从性似乎并不取决于患者的性别、种族或预后。
