结直肠癌患者经济毒性的危险因素分析  

Risk factors analysis of financial toxicity in colorectal cancer patients

作　　者：程珂 曹希 黎燕红[1] 甘肖勤[1] 刘艳平[3] 阮蕾[4] CHENG Ke;CAO Xi;LI Yanhong;GAN Xiaoqin;LIU Yanping;RUAN Lei(Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou 510655,China;School of Nursing,Sun Yat-sen University,Guangzhou 510000,China)

机构地区：[1]中山大学附属第六医院肿瘤科,广东广州510655 [2]中山大学护理学院,广东广州510000 [3]中山大学附属第六医院放疗科,广东广州510655 [4]中山大学附属第六医院结直肠外科,广东广州510655

出　　处：《中华肿瘤防治杂志》2023年第16期984-989,共6页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的 探讨结直肠癌患者经济毒性的危险因素,为识别高危人群提供参考依据。方法 选取2022-02-01-2022-06-30中山大学附属第六医院肿瘤科和结直肠外科收治的371例结直肠癌患者为研究对象。运用一般资料调查表和中文版经济毒性综合评分量表(COST)进行问卷调查。通过单因素分析和二元logistic回归分析,筛选出结直肠癌患者经济毒性的危险因素。结果 结直肠癌患者COST得分为17分(8~23分),平均得分为(15.464±9.369)分。根据COST得分中位数将经济毒性分为高经济毒性(≤17分)和低经济毒性(>17分)组。其中196例(52.83%)患者为高经济毒性,175例(47.17%)为低经济毒性。单因素分析结果显示,2组患者在教育程度(χ^(2)=8.185,P=0.042)、居住地(χ^(2)=31.132,P<0.001)、工作状态(χ^(2)=38.295,P<0.001)、家庭人均月收入(χ^(2)=49.679,P<0.001)、医疗费用支付方式(χ^(2)=21.569,P<0.001)、有无因治疗借贷(χ^(2)=35.801,P<0.001)、临床分期(χ^(2)=14.460,P=0.001)、有无远处转移(χ^(2)=14.407,P<0.001)、确诊时长(χ^(2)=4.292,P=0.038)、有无靶向治疗(χ^(2)=5.119,P=0.024)、化疗周期(χ^(2)=10.556,P=0.001)、有无造口(χ^(2)=7.836,P=0.005)和有无慢性疾病(χ^(2)=5.475,P=0.019)方面差异均有统计学意义。二元logistic回归分析结果显示,失业(OR=2.964,95%CI:1.579~5.566)、家庭人均月收入≤5 000元(OR=3.511,95%CI:2.077~5.937)、有因治疗借贷(OR=2.653,95%CI:1.559~4.516)、临床分期为Ⅳ期(OR=1.903,95%CI:1.177~3.075)、化疗周期≥4个周期(OR=1.849,95%CI:1.140~2.997)和有造口(OR=2.275,95%CI:1.083~4.780)是结直肠癌患者高经济毒性的危险因素,均P<0.05。结论 结直肠癌患者高经济毒性的发生率较高,早期识别结直肠癌患者经济毒性危险因素,并制定相应防控策略,可降低结直肠癌患者的经济毒性。Objective To explore the risk factors of financial toxicity in colorectal cancer patients,and provide a reference for identifying high-risk people.Methods A total of 371 colorectal cancer patients admitted to the Department of Oncology and Colorectal Surgery of Sixth Affiliated Hospital of Sun Yat-sen University from February 2022 to June 2022 were recruited.A questionnaire survey was conducted.Participants were asked to complete the general information questionnaire and the Chinese version of comprehensive score for financial toxicity(COST).Univariate analysis and binary logistic regression analysis were used to explore risk factors associated with financial toxicity.Results The median COST score of colorectal cancer patients was 17 points(8-23 points),with an average score of(15.464±9.369) points.According to the median COST score,financial toxicity was divided into high(≤17 points) and low(>17 points) financial toxicity groups.Among colorectal cancer patients,196 patients(52.83%) had high financial toxicity and 175 patients(47.17%)had low financial toxicity.The differences of two groups were statistically significant(P<0.05) in education(χ^(2)=8.185,P=0.042),place of residence(χ^(2)=31.132,P<0.001),employment status(χ^(2)=38.295,P<0.001),monthly household income(χ^(2)=49.679,P<0.001),modes of payment for medical expenses(χ^(2)=21.569,P<0.001),borrowing money for treatment(χ^(2)=35.801,P<0.001),clinical stage(χ^(2)=14.460,P=0.001),distant metastases(χ^(2)=14.407,P<0.001),length of being diagnosed(χ^(2)=4.292,P=0.038),targeted therapy(χ^(2)=5.119,P=0.024),courses of chemotherapy(χ^(2)=10.556,P=0.001),stoma(χ^(2)=7.836,P=0.005),and chronic diseases(χ^(2)=5.475,P=0.019).Binary logistic regression analysis showed that unemployment(OR=2.964,95%CI:1.579-5.566),monthly household income≤5000yuan(OR=3.511,95 % CI:2.077-5.937),borrowing money for treatment(OR=2.653,95 %CI:1.559-4.516),clinical stage Ⅳ(OR=1.903,95%CI:1.177-3.075),chemotherapy cycle≥4 courses(OR=1.849,95%CI:1.140-2.997),ostomy(OR=2.27

关 键 词：结直肠癌 癌症 经济毒性 经济负担 危险因素 回归分析 

分 类 号：R735.34[医药卫生—肿瘤]