乳腺癌内分泌治疗依从性研究  

Breast cancer patient compliance with endocrine therapy

作　　者：李丽[1] 秦建伟[1] 韦达[1] 吴建中[1] 唐金海[1] 

机构地区：[1]南京医科大学附属江苏省肿瘤医院普外科,江苏210009

出　　处：《中华内分泌外科杂志》2014年第5期359-361,共3页Chinese Journal of Endocrine Surgery

基　　金：国家自然科学基金项目（81272470）

摘　　要：目的 了解乳腺癌内分泌治疗的依从性,分析影响内分泌治疗正确率的相关因素.方法 对2006年6月至2008年6月在江苏省肿瘤医院住院治疗的379例激素受体阳性乳腺癌患者进行规范的电话随访,记录内分泌治疗完成情况,对成功随访病例进行依从性相关因素分析.结果 85.0％（322/379）成功随访,其中4.7％（15/322）完全未接受内分泌治疗,13.4％ （43/322）院外服用一段时间后自行停药,4.3％（14/322）无规律间断服药,250例规律完成了5年的口服内分泌治疗,治疗正确率为77.6％ （250/322）.定量资料采用t检验和单因素方差分析发现,患者停药高峰主要集中在初始服药2个月内和2年内,分别占39.5％和48.8％;停药人群与患者所从事职业和受教育程度表现出相关性（初中以上及以下学历人群停药率分别为29.4％ vs 19.8％,P＜0.001）,停药原因主要为对副作用的过度担心和难以坚持长期服药.结论 内分泌治疗对激素受体阳性患者疗效肯定,已作为乳腺癌的常规治疗手段应用于临床,但由于治疗时间长、院外服药缺乏监管,使得内分泌治疗的正确率和依从性较低,很大程度降低了乳腺癌治疗疗效.如何对行内分泌治疗的患者进行科学管理,提高治疗依从性和疗效,值得医务人员探讨.Objective To investigate the compliance with endocrine therapy（ET） and assess the factors associated with treatment accuracy for breast cancer.Methods 379 patients with hormone receptor-positive breast cancer undergoing complete treatment from Jun.2006 to Jun.2008 in Jiangsu Cancer Hospital were followed up.Factors related to compliance were analyzed.Results Among the 322 （85.0％） patients successfully interviewed,15 （4.7％） patients did not receive ET,43 （13.4％） patients stopped taking drugs after discharge,14 （4.3％）patients had intermittent ET,and the rest 250 patients obeyed 5-year oral ET regularly.The treatment accuracy was 77.6％ （250/332）.We found that majority of withdraw occurred within 2 months and within 2 years,accounting for 39.5％ and 48.8％,respectively.Job and education status were relevant to these patients.Moreover,too much concern of adverse drug effects and difficulty of long-term medication were the main reasons to noncompliance.Conclusions ET is effective in hormone receptor-positive breast cancer patients and has been used as a conventional therapy.However,due to the long therapeutic period and lack of medical supervision after discharge,its treatment accuracy and compliances are becoming low,resulting in decreased efficiency.It is therefore necessary to investigate such patients＇ management to improve the compliance and treatment accuracy of ET.

关 键 词：乳腺癌 内分泌治疗 依从性 

分 类 号：R737.9[医药卫生—肿瘤]