Objective：Adjuvant docetaxel-based chemotherapy is frequently used for operable early breast cancer（EBC）.This study investigated patterns of use of docetaxel（T）in real-life clinical practice in China.Methods：Thi...Objective：Adjuvant docetaxel-based chemotherapy is frequently used for operable early breast cancer（EBC）.This study investigated patterns of use of docetaxel（T）in real-life clinical practice in China.Methods：This was a retrospective pooled analysis of the Asia-Pacific Breast Initiatives（APBI）Ⅰ（2006–2008）and Ⅱ（2009–2011）registries,and two Chinese observational studies;BC STATE（2011–2014）and BC Local Registry（2007–2010）.Female Chinese adults（≥18 years）with operable breast cancer treated with docetaxel-based adjuvant chemotherapy were included in the analysis.Patients with metastatic disease were excluded.The primary endpoint was assessment of treatment patterns and patient profiles.A logistic regression analysis was conducted to identify factors associated with choice of adjuvant chemotherapy regimen.Results：Data from 3,020 patients were included.The most frequently used adjuvant regimen was docetaxel/anthracycline combination[n=1,421（47.1%）;of whom 52.0%received T/epirubicin（E）/cyclophosphamide（C）],followed by docetaxel/other[n=705（23.3%）;of whom 72.8%received TC],docetaxel/anthracycline sequential[n=447（14.8%）;of whom 40.9%and 39.6%received 5-Fu/EC-T and EC-T,respectively],and＂other＂[n=447（14.8%）;of whom 91.5%received T].A significant association was found between adjuvant therapy with docetaxel/anthracycline combination and patient weight,menopausal status and estrogen receptor status.Conclusions：Real-world data revealed that docetaxel/anthracycline combination is the most commonly used category of docetaxel-based adjuvant therapy for patients with operable breast cancer in China;of which TEC is the most frequently used regimen.展开更多
目的本共识的制定旨在为肿瘤重症患者合并呼吸衰竭的临床处理中常见问题提供基于临床证据的推荐意见。方法采用人群、干预、比较和预后(Population,Intervention,Comparison,and Outcome,PICO)原则对肿瘤重症患者呼吸衰竭的诊断和处理提...目的本共识的制定旨在为肿瘤重症患者合并呼吸衰竭的临床处理中常见问题提供基于临床证据的推荐意见。方法采用人群、干预、比较和预后(Population,Intervention,Comparison,and Outcome,PICO)原则对肿瘤重症患者呼吸衰竭的诊断和处理提出6个重要临床问题,基于文献检索和证据整合形成推荐意见。采用推荐意见分级评价、制定与评估(Grading of Recommendation Assessment,Development and Evaluation,GRADE)的方法讨论每个问题并经专家组讨论后形成共识意见。结果共识专家组形成了如下推荐意见。强推荐:(1)宏基因组二代测序可能有助于临床医师快速诊断合并呼吸衰竭的肿瘤重症患者的肺部感染;(2)体外膜肺(Extracorporeal Membrane Oxygenation,ECMO)不作为合并急性呼吸窘迫综合征的肿瘤重症患者常规挽救方案,多学科会诊后高选择性患者可能受益于ECMO治疗;(3)与标准化疗相比,免疫检查点抑制剂治疗增加肿瘤患者肺毒性的发生率;(4)接受机械通气的肿瘤患者如预计通气时间超过14天,早期气管切开可能使患者获益;(5)高流量氧疗和无创通气可以作为肿瘤合并呼吸衰竭的重症患者的一线氧疗方案。弱推荐:(6)对于癌肿压迫所致呼吸衰竭的肿瘤重症患者,如多学科会诊后考虑肿瘤对于药物潜在敏感,可采用紧急化疗作为挽救治疗。结论基于已有证据形成的推荐意见可指导肿瘤合并呼吸衰竭患者的诊断和治疗并改善预后。展开更多
Purpose Intensive postoperative chemotherapy treatment use in early-onset colon cancer and late-onset colon cancer remains to be defined and their effects on prognosis were unclear.This study aims to investigate wheth...Purpose Intensive postoperative chemotherapy treatment use in early-onset colon cancer and late-onset colon cancer remains to be defined and their effects on prognosis were unclear.This study aims to investigate whether intensive adjuvant chemotherapy for stageⅡcolon cancer would result in matched survival improvement in young patients(<50 years)without risk factors and old-aged(70–85 years)patients with risk factors defined by guidelines.Methods We extracted eligible patients with pathologically confirmed TNM stageⅡcolon cancer from the Surveillance,Epidemiology,and End Results database between 2004 and 2015.Patients aged<50 years old without risk factors were defined as non-high-risk early-onset colon cancer(non-HREOCC),and those aged 70 to 85 years with risk factors were defined as high-risk late-onset colon cancer(HRLOCC).Kaplan–Meier(KM)method with log-rank test was performed to calculate the overall survival(OS)and cancer-specific survival(CSS).Multivariate Cox model was used to estimate the association of adjuvant chemotherapy with CSS by adjusting potential confounding factors.Results Of 55,366 eligible stageⅡcolon cancer patients,3341 non-HREOCC patients and 11,722 HRLOCC patients were included.37.68%and 16.8%of patients received adjuvant chemotherapy among non-HREOCC and HRLOCC patients,respectively.For non-HREOCC patients,there was no significant association between adjuvant chemotherapy and CSS(HR=1.09,95%CI0.83–1.44).For HRLOCC patients,adjuvant chemotherapy was associated with a better CSS(HR=0.88,95%CI0.79–0.99).Conclusion Our findings suggested that potential overuse of adjuvant chemotherapy among non-high-risk young patients with stageⅡcolon cancer did not lead to survival improvement,and caution should be called when using chemotherapy in these patients.However,chemotherapy can be used appropriately for high-risk stageⅡcolon cancer patients aged 70 to 85 years.展开更多
文摘Objective：Adjuvant docetaxel-based chemotherapy is frequently used for operable early breast cancer（EBC）.This study investigated patterns of use of docetaxel（T）in real-life clinical practice in China.Methods：This was a retrospective pooled analysis of the Asia-Pacific Breast Initiatives（APBI）Ⅰ（2006–2008）and Ⅱ（2009–2011）registries,and two Chinese observational studies;BC STATE（2011–2014）and BC Local Registry（2007–2010）.Female Chinese adults（≥18 years）with operable breast cancer treated with docetaxel-based adjuvant chemotherapy were included in the analysis.Patients with metastatic disease were excluded.The primary endpoint was assessment of treatment patterns and patient profiles.A logistic regression analysis was conducted to identify factors associated with choice of adjuvant chemotherapy regimen.Results：Data from 3,020 patients were included.The most frequently used adjuvant regimen was docetaxel/anthracycline combination[n=1,421（47.1%）;of whom 52.0%received T/epirubicin（E）/cyclophosphamide（C）],followed by docetaxel/other[n=705（23.3%）;of whom 72.8%received TC],docetaxel/anthracycline sequential[n=447（14.8%）;of whom 40.9%and 39.6%received 5-Fu/EC-T and EC-T,respectively],and＂other＂[n=447（14.8%）;of whom 91.5%received T].A significant association was found between adjuvant therapy with docetaxel/anthracycline combination and patient weight,menopausal status and estrogen receptor status.Conclusions：Real-world data revealed that docetaxel/anthracycline combination is the most commonly used category of docetaxel-based adjuvant therapy for patients with operable breast cancer in China;of which TEC is the most frequently used regimen.
文摘目的本共识的制定旨在为肿瘤重症患者合并呼吸衰竭的临床处理中常见问题提供基于临床证据的推荐意见。方法采用人群、干预、比较和预后(Population,Intervention,Comparison,and Outcome,PICO)原则对肿瘤重症患者呼吸衰竭的诊断和处理提出6个重要临床问题,基于文献检索和证据整合形成推荐意见。采用推荐意见分级评价、制定与评估(Grading of Recommendation Assessment,Development and Evaluation,GRADE)的方法讨论每个问题并经专家组讨论后形成共识意见。结果共识专家组形成了如下推荐意见。强推荐:(1)宏基因组二代测序可能有助于临床医师快速诊断合并呼吸衰竭的肿瘤重症患者的肺部感染;(2)体外膜肺(Extracorporeal Membrane Oxygenation,ECMO)不作为合并急性呼吸窘迫综合征的肿瘤重症患者常规挽救方案,多学科会诊后高选择性患者可能受益于ECMO治疗;(3)与标准化疗相比,免疫检查点抑制剂治疗增加肿瘤患者肺毒性的发生率;(4)接受机械通气的肿瘤患者如预计通气时间超过14天,早期气管切开可能使患者获益;(5)高流量氧疗和无创通气可以作为肿瘤合并呼吸衰竭的重症患者的一线氧疗方案。弱推荐:(6)对于癌肿压迫所致呼吸衰竭的肿瘤重症患者,如多学科会诊后考虑肿瘤对于药物潜在敏感,可采用紧急化疗作为挽救治疗。结论基于已有证据形成的推荐意见可指导肿瘤合并呼吸衰竭患者的诊断和治疗并改善预后。
基金The Fundamental Research Funds for the Central Universities(No.226–2022-00009)the Project of the regional diagnosis and treatment center of the Health Planning Committee(No.JBZX-201903).
文摘Purpose Intensive postoperative chemotherapy treatment use in early-onset colon cancer and late-onset colon cancer remains to be defined and their effects on prognosis were unclear.This study aims to investigate whether intensive adjuvant chemotherapy for stageⅡcolon cancer would result in matched survival improvement in young patients(<50 years)without risk factors and old-aged(70–85 years)patients with risk factors defined by guidelines.Methods We extracted eligible patients with pathologically confirmed TNM stageⅡcolon cancer from the Surveillance,Epidemiology,and End Results database between 2004 and 2015.Patients aged<50 years old without risk factors were defined as non-high-risk early-onset colon cancer(non-HREOCC),and those aged 70 to 85 years with risk factors were defined as high-risk late-onset colon cancer(HRLOCC).Kaplan–Meier(KM)method with log-rank test was performed to calculate the overall survival(OS)and cancer-specific survival(CSS).Multivariate Cox model was used to estimate the association of adjuvant chemotherapy with CSS by adjusting potential confounding factors.Results Of 55,366 eligible stageⅡcolon cancer patients,3341 non-HREOCC patients and 11,722 HRLOCC patients were included.37.68%and 16.8%of patients received adjuvant chemotherapy among non-HREOCC and HRLOCC patients,respectively.For non-HREOCC patients,there was no significant association between adjuvant chemotherapy and CSS(HR=1.09,95%CI0.83–1.44).For HRLOCC patients,adjuvant chemotherapy was associated with a better CSS(HR=0.88,95%CI0.79–0.99).Conclusion Our findings suggested that potential overuse of adjuvant chemotherapy among non-high-risk young patients with stageⅡcolon cancer did not lead to survival improvement,and caution should be called when using chemotherapy in these patients.However,chemotherapy can be used appropriately for high-risk stageⅡcolon cancer patients aged 70 to 85 years.
