设定基准:2011-2017年澳大利亚昆士兰州早期非小细胞肺癌的护理模式和结局。

IF 1.6 4区 医学 Q4 ONCOLOGY
Bryan A Chan, Danny R Youlden, Tracey Guan, Margot Lehman, Morgan Windsor, Alison Bolton, Nathan Dunn, Danica Cossio, Shoni Philpot, Jasotha Sanmugarajah
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引用次数: 0

摘要

目的:早期非小细胞肺癌(NSCLC)的治疗模式正在迅速发展。我们的目的是记录在引入免疫治疗之前人群水平的基线护理模式和结果。方法:数据来自昆士兰肿瘤信息库。该研究队列包括2011年至2017年期间被诊断为非转移性原发性NSCLC的昆士兰居民,随访治疗和死亡率至2022年12月31日。泊松回归用于确定诊断1年内接受不同治疗方式的患者和临床特征。采用灵活参数模型评估5年观察生存率的变化。结果:共纳入4445例患者,其中30%为单纯手术治疗,15%为手术加化疗和/或放疗,44%为单纯化疗和/或放疗。其余10%未接受任何记录治疗。外围地区/偏远地区的人群放疗率(相对似然[RL] = 0.87, 95%可信区间[CI] 0.78 ~ 0.97)和化疗率(RL = 0.89, 95% CI 0.81 ~ 0.98)低于大城市人群,但原住民身份和社会经济地位之间没有显著差异。5年观察生存率从I期的63% (95% CI 60%-65%)到II期的41%(38%-45%)和III期的20%(18%-22%)不等。治疗方式显著影响生存率,与诊断分期无关(均p < 0.001)。结论:在人群水平上监测早期非小细胞肺癌的治疗结果对于优化患者护理、资源分配和告知消费者选择至关重要。包括免疫治疗在内的新方法有望进一步改善结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Setting the Benchmark: Patterns of Care and Outcomes for Early-stage Non-small Cell Lung Cancer in Queensland, Australia, 2011-2017.

Aim: Treatment paradigms for early-stage non-small cell lung cancer (NSCLC) are evolving rapidly. Our aim was to document baseline patterns of care and outcomes at the population level immediately prior to the introduction of immunotherapy.

Methods: Data were obtained from the Queensland Oncology Repository. The study cohort comprised Queensland residents diagnosed with a non-metastatic primary NSCLC between 2011 and 2017, with follow-up on treatment and mortality to December 31, 2022. Poisson regression was used to determine patient and clinical characteristics associated with receiving different treatment modalities within 1 year of diagnosis. Variations in 5-year observed survival were assessed using flexible parametric modelling.

Results: A total of 4445 people were included, of whom 30% were treated with surgery only, 15% with surgery plus chemotherapy and/or radiotherapy and 44% with chemotherapy and/or radiotherapy only. The remaining 10% did not receive any recorded treatment. People in outer regional/remote areas had lower rates of radiotherapy (relative likelihood [RL] = 0.87, 95% confidence interval [CI] 0.78-0.97) and chemotherapy (RL = 0.89, 95% CI 0.81-0.98) than those in major cities, but there were no significant differences by First Nations status or socio-economic status. Five-year observed survival varied from 63% (95% CI 60%-65%) for stage I to 41% (38%-45%) for stage II and 20% (18%-22%) for stage III. The treatment modality significantly affected survival irrespective of stage at diagnosis (all p < 0.001).

Conclusion: Monitoring treatment outcomes for early-stage NSCLC at the population level is crucial for optimizing patient care, resource allocation and informing consumer choice. Emerging approaches involving immunotherapy are expected to further improve outcomes.

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来源期刊
CiteScore
3.40
自引率
0.00%
发文量
175
审稿时长
6-12 weeks
期刊介绍: Asia–Pacific Journal of Clinical Oncology is a multidisciplinary journal of oncology that aims to be a forum for facilitating collaboration and exchanging information on what is happening in different countries of the Asia–Pacific region in relation to cancer treatment and care. The Journal is ideally positioned to receive publications that deal with diversity in cancer behavior, management and outcome related to ethnic, cultural, economic and other differences between populations. In addition to original articles, the Journal publishes reviews, editorials, letters to the Editor and short communications. Case reports are generally not considered for publication, only exceptional papers in which Editors find extraordinary oncological value may be considered for review. The Journal encourages clinical studies, particularly prospectively designed clinical trials.
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