2020 年前澳大利亚新南威尔士州按治疗年代分列的多发性骨髓瘤存活率。

IF 5.6 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
Eleonora Feletto, Qingwei Luo, Anna Kelly, Marianne Weber, David Goldsbury, Katherine Barron, Karen Canfell, Xue Qin Yu
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引用次数: 0

摘要

目的:澳大利亚的多发性骨髓瘤(MM)发病率和死亡率相对较高。近几十年来,多发性骨髓瘤治疗的进步推动了高收入国家多发性骨髓瘤存活率的提高;然而,澳大利亚的报告却很有限。我们调查了澳大利亚新南威尔士州(NSW)3个治疗进展时期全人口多发性骨髓瘤存活率的时间趋势:根据诊断日期,将1985年至2015年期间在新南威尔士州癌症登记处确诊为MM并进行重要随访至2020年的患者分为3个先前定义的治疗时期(1985年至1995年,仅采用化疗;1996年至2007年,采用自体干细胞移植;2008年至2015年,采用新型药物,包括蛋白酶体抑制剂和免疫调节药物)。根据Fine和Gray的竞争风险累积发病率函数,按治疗年代和诊断时的年龄计算相对存活率和病因特异性存活率:研究共纳入 11,591 人,诊断时的中位年龄为 70 岁。在36年(1985-2020年)的研究期间,五年相对生存率有所提高(1985-1995年为31.0%;1996-2007年为41.9%;2008-2015年为56.1%)。对于 70 岁之前确诊的患者,5 年相对生存率几乎翻了一番,从 1985-1995 年的 36.5% 提高到 2008-2015 年的 68.5%。1985-1995年和1996-2007年期间,年龄大于70岁的患者的改善并不明显;然而,在2008-2015年期间,确诊患者的情况有了显著改善。在病因特异性生存率方面,也观察到了类似的总体模式和年龄特异性模式。在对性别和诊断时的年龄进行调整后,治疗年代与相对存活率和病因特异性存活率密切相关(P < 0.0001):结论:随着治疗技术的进步,澳大利亚 MM 患者的生存率正在提高。结论:随着治疗技术的进步,澳大利亚 MM 患者的生存率也在不断提高,然而,老年患者的生存率仍然较低,而且随着时间的推移仅略有改善。鉴于MM在澳大利亚的发病率越来越高,MM治疗对生活质量的影响,尤其是对老年患者的生活质量的影响,值得进一步关注。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Multiple myeloma survival in New South Wales, Australia, by treatment era to 2020.

Objective: Australia has relatively high multiple myeloma (MM) incidence and mortality rates. Advancements in MM treatment over recent decades have driven improvements in MM survival in high-income countries; however, reporting in Australia is limited. We investigated temporal trends in population-wide MM survival across 3 periods of treatment advancements in New South Wales (NSW), Australia.

Methods: Individuals with an MM diagnosis in the NSW Cancer Registry between 1985 and 2015 with vital follow-up to 2020, were categorized into 3 previously defined treatment eras according to their diagnosis date (1985-1995, chemotherapy only; 1996-2007, autologous stem cell transplantation; and 2008-2015, novel agents including proteasome inhibitors and immunomodulatory drugs). Both relative survival and cause-specific survival according to Fine and Gray's competing risks cumulative incidence function were calculated by treatment era and age at diagnosis.

Results: Overall, 11,591 individuals were included in the study, with a median age of 70 years at diagnosis. Five-year relative survival improved over the 36-year (1985-2020) study period (31.0% in 1985-1995; 41.9% in 1996-2007; and 56.1% in 2008-2015). For individuals diagnosed before 70 years of age, the 5-year relative survival nearly doubled, from 36.5% in 1985-1995 to 68.5% in 2008-2015. Improvements for those > 70 years of age were less pronounced between 1985-1995 and 1996-2007; however, significant improvements were observed for those diagnosed in 2008-2015. Similar overall and age-specific patterns were observed for cause-specific survival. After adjustment for gender and age at diagnosis, treatment era was strongly associated with both relative and cause-specific survival (P < 0.0001).

Conclusions: Survival of individuals with MM is improving in Australia with treatment advances. However, older age groups continue to experience poor survival outcomes with only modest improvements over time. Given the increasing prevalence of MM in Australia, the effects of MM treatment on quality of life, particularly in older age, warrant further attention.

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来源期刊
Cancer Biology & Medicine
Cancer Biology & Medicine Medicine-Oncology
CiteScore
9.80
自引率
3.60%
发文量
1143
审稿时长
12 weeks
期刊介绍: Cancer Biology & Medicine (ISSN 2095-3941) is a peer-reviewed open-access journal of Chinese Anti-cancer Association (CACA), which is the leading professional society of oncology in China. The journal quarterly provides innovative and significant information on biological basis of cancer, cancer microenvironment, translational cancer research, and all aspects of clinical cancer research. The journal also publishes significant perspectives on indigenous cancer types in China.
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