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題名:乳癌病人使用Tamoxifen治療時間對其存活之影響
書刊名:醫務管理期刊
作者:歐子綺常傳訓黃純文陳楚杰呂友敏
作者(外文):Ou, Tzu-chiChang, Chuan-hsunHuang, Chun-wenChen, Chu-chiehLu, You-min
出版日期:2019
卷期:20:1
頁次:頁1-14
主題關鍵詞:乳癌泰莫西芬治療時間存活Breast cancerTamoxifenTAMTreatment timeSurvival
原始連結:連回原系統網址new window
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  • 點閱點閱:7
目的:本研究旨在探討2000年至2005年新發乳癌病人使用泰莫西芬(Tamoxifen, TAM)治療時間對其存活之影響。方法:本研究利用全民健康保險研究資料庫進行分析,以百分比呈現類別變項分佈情形,並以每千人年呈現TAM乳癌病人的全死因發生密度;推論性統計分析利用對數等級檢定評估不同治療時間乳癌病人的存活率。結果:研究期間新發乳癌病人共561位其平均年齡、Charlson Comorbidity Index(CCI)得分及治療時間分別為50.69歲,0.34分,3.29年;追蹤乳癌病人5,540人年共78個死亡,發生密度為14.08。Kaplan-Meier分析結果顯示,TAM治療時間越短存活率越低。控制其他變項後,獨立影響乳癌病人存活的因素有年別、年齡層別、CCI得分及治療時間類別。結論:乳癌病人接受TAM治療時間大於5年的存活率較2年以下及2至5年佳,相關單位應向民眾宣導勿擅自停藥,以延長乳癌病人的存活時間。
Objectives: The purpose of this study is to explore the impact of Tamoxifen treatment time on new-onset breast cancer patients on their survival from 2000 to 2005. Methods: This study used the National Health Insurance research database released by the National Health Research Institute (NHRI) and the distributions of category variables were presented as percentages. Then, the densities of breast cancer patient mortality were presented per 1,000 persons. Evaluation of survival rate of breast cancer patients at different treatment times using a log- rank test. Results: From 2000 to 2005, there were 561 patients newly diagnosed with breast cancer. In terms of basic data, the patients' average age, Charlson Comorbidity Index score and treatment time were 50.69 years, 0.34 points, and 3.29 years, respectively. In terms of the densities of incidences of all causes of death, tracking 78 cancer deaths in 5,540 person-years of breast cancer patients (the incidence density was 14.08 per 1,000 person-years). Kaplan-Meier's analysis results showed that the shorter the TAM treatment time, the lower the survival rate. After exerting control on the other variables, the factors independently affecting the survival of breast cancer patients in the TAM group include: year, age bracket, CCI category, and treatment time category. Conclusions: The survival rate of treatment times more than 5 years is better than that of less than 2 years and 2 to 5 years. Relevant agencies should advocate to the general public not to arbitrarily stop medications in order to prolong the survival time of breast cancer patients.
期刊論文
1.郭文宏(20130700)。乳癌的荷爾蒙治療。臺灣醫學,17(4),397-403。  延伸查詢new window
2.陳昭姿(20090800)。Letrozole (Femara®)--乳癌荷爾蒙療法的理想選項。當代醫學,36(8)=430,619-623。  延伸查詢new window
3.楊媛婷(2016)。淺談乳癌荷爾蒙療法之概況。彰基藥訊,24(3),1-4。  延伸查詢new window
4.Davies, C.、Pan, H.、Peto, R.(2017)。10 vs 5 years of adjuvant tamoxifen: Exclusion of 1/402 centres in ATLAS。The Lancet,389(10082),1884。  new window
5.Davies, C.、Pan, H.、Godwin, J.、Gray, R.、Arriagada, R.、Raina, V.、Peto, R.(2013)。Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial。The Lancet,381(9869),805-816。  new window
6.Early Breast Cancer Trialists' Collaborative Group(1998)。Tamoxifen for early breast cancer: an overview of the randomised trials。The Lancet,351(9114),1451-1467。  new window
7.Early Breast Cancer Trialists' Collaborative Group(2005)。Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: An overview of the randomised trials。The Lancet,365(9472),1687-1717。  new window
8.Early Breast Cancer Trialists' Collaborative Group(2011)。Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: Patient-level meta-analysis of randomised trials。The lancet,378(9793),771-784。  new window
9.Fisher, B.、Dignam, J.、Bryant, J.、Wolmark, N.(2001)。Five versus more than five years of tamoxifen for lymph node-negative breast cancer: Updated findings from the National Surgical Adjuvant Breast and Bowel Project B-14 randomized trial。Journal of the National Cancer Institute,93(9),684-690。  new window
10.Hankinson, S. E.、Colditz, G. A.、Willett, W. C.(2004)。Towards an integrated model for breast cancer etiology: The lifelong interplay of genes, lifestyle, and hormones。Breast Cancer Research,6(5),213-218。  new window
11.Hsieh, K. P.、Chen, L. C.、Cheung, K. L.、Chang, C. S.、Yang, Y. H.(2014)。Interruption and non-adherence to long-term adjuvant hormone therapy is associated with adverse survival outcome of breast cancer women--an Asian population-based study。Public Library of Science One,9(2),e87027。  new window
12.Johnston, S. R.、Dowsett, M.(2003)。Aromatase inhibitors for breast cancer: Lessons from the laboratory。Nature Reviews Cancer,3(11),821-831。  new window
13.Khalis, M.、Charbotel, B.、Chajes, V.、Rinaldi, S.、Moskal, A.、Biessy, C.、Elfakir, S.(2018)。Menstrual and reproductive factors and risk of breast cancer: A case-control study in the Fez region, Morocco。PloS One,13(1),e0191333。  new window
14.Peto, R.(1996)。Five years of tamoxifen--or more?。Journal of the National Cancer Institute,88(24),1791-1793。  new window
15.Tormey, D. C.、Gray, R.、Falkson, H. C.(1996)。Postchemotherapy adjuvant tamoxifen therapy beyond five years in patients with lymph node-positive breast cancer。Journal of the National Cancer Institute,88(24),1828-1833。  new window
研究報告
1.衛生福利部統計處(2017)。105年國人死因統計結果分析。  延伸查詢new window
2.衛生福利部中央健保署(2016)。全民健保特約醫療院所數。  延伸查詢new window
其他
1.National Comprehensive Cancer Network(2016)。About the NCCN clinical practice guidelines in oncology (NCCN Guidelines®),https://www.nccn.org/professionals/default.aspx, 。  new window
 
 
 
 
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