東華大學圖書館 |

語系: 繁體中文

說明(常見問題)

回圖書館首頁

手機版館藏查詢

登入

回首頁 到查詢結果 [ subject:"Health sciences." ]

切換: 標籤 | MARC模式 | ISBD

Treatment Interruption and Discontin...

Mao, Daqin .

FindBook

Google Book

Amazon

博客來

Treatment Interruption and Discontinuation of Hormone Therapy in Hormone Receptor-Positive Breast Cancer Patients.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Treatment Interruption and Discontinuation of Hormone Therapy in Hormone Receptor-Positive Breast Cancer Patients./
作者:	Mao, Daqin .
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2020,
面頁冊數:	103 p.
附註:	Source: Masters Abstracts International, Volume: 81-08.
Contained By:	Masters Abstracts International81-08.
標題:	Health sciences. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=27545750
ISBN:	9781658406772

Treatment Interruption and Discontinuation of Hormone Therapy in Hormone Receptor-Positive Breast Cancer Patients.
Mao, Daqin .

Treatment Interruption and Discontinuation of Hormone Therapy in Hormone Receptor-Positive Breast Cancer Patients. - Ann Arbor : ProQuest Dissertations & Theses, 2020 - 103 p.

Source: Masters Abstracts International, Volume: 81-08.

Thesis (M.S.)--Sackler School of Graduate Biomedical Sciences (Tufts University), 2020.

This item must not be sold to any third party vendors.

Adjuvant hormone therapy (HT) with tamoxifen and aromatase inhibitors signiﬁcantly prolongs disease-free and overall survival time and is the recommended standard of care for women with early-stage breast cancer, yet suboptimal adherence is common. We aimed to further our understanding of patterns of HT use, speciﬁcally focusing on the prevalence and predictors of treatment interruptions (gaps exceeding 14 days but less than 180 days) and discontinuation (first gap exceeding 180 days) of HT. We identiﬁed 201 women who were diagnosed with stage I-III breast cancer between 2009-2015 and who initiated adjuvant HT, and were followed through December 31, 2016, at Tufts Medical Center. Of the 201 women with HR-positive tumors, 53 (26.4%) were initiated with a selective estrogen receptor modulator (SERM) and 148 (73.6%) with an aromatase inhibitor (AI). Median follow-up time was 3 years (IQR 1.5-4.5). During the follow-up period, 22 (10.9%) stopped taking prescribed HT with a median duration of 1.5 years (IQR 0.7-2.4), and 47 (23.4%) had at least one treatment interruption. Among those who ever had treatment interruption(s), 30 (63.8%) experienced the first treatment interruption within one year after HT initiation, and 13 (27.7%) eventually discontinued therapy. Regarding the pre-HT factors, results from adjusted Cox proportional hazards regression models indicated that women with pre-existing psycho-affective disorders were more likely to discontinue therapy (HR 3.15, 95%CI 1.35-7.37, P = 0.008); whereas pre-existing pain disorders were associated with earlier treatment interruption of HT (HR 2.24, 95%CI 1.20-4.19, P = 0.012). Mediation analysis found a statistically significant indirect effect of treatment interruption (0.052, 95%CI 0.007-0.10, P = 0.014) that accounted for 35.4% (95%CI 24-123%, P = 0.024) of the total effect of pre-existing psycho-affective disorders on early discontinuation, suggesting that a potential mediating role of treatment interruption in the relation between pre-existing psycho-affective disorders and early discontinuation. After HT initiation, HT-related symptoms were prevalent and the most common reason reported for interrupting or discontinuing therapy. Women who experienced severe treatment-related symptoms were at increased risk for both discontinuing therapy (HR 3.48, 95%CI 1.20-10.1, P = 0.022) and having earlier treatment interruption (HR 2.64, 95%CI 1.07-6.50, P = 0.035). In summary, treatment interruptions of HT were common and might be part of the causal pathway between pre-existing psycho-affective disorder and HT discontinuation. Both pre-existing disorders and HT-related symptoms may contribute to interrupted or discontinued therapy. Clinicians caring for breast cancer patients receiving HT should closely monitor their medication use and treatment-emergent symptoms, and encourage them to continue therapy through symptom management and patient-centered approaches.

ISBN: 9781658406772Subjects--Topical Terms:

3168359
Health sciences.

Treatment Interruption and Discontinuation of Hormone Therapy in Hormone Receptor-Positive Breast Cancer Patients.
LDR:03971nmm a2200289 4500 001 2264366
005 20200423113022.5
008 220629s2020 ||||||||||||||||| ||eng d
020 $a 9781658406772
035 $a (MiAaPQ)AAI27545750
035 $a AAI27545750
040 $a MiAaPQ $c MiAaPQ
100 1 $a Mao, Daqin . $3 3541481
245 1 0 $a Treatment Interruption and Discontinuation of Hormone Therapy in Hormone Receptor-Positive Breast Cancer Patients.
260 1 $a Ann Arbor : $b ProQuest Dissertations & Theses, $c 2020
300 $a 103 p.
500 $a Source: Masters Abstracts International, Volume: 81-08.
500 $a Advisor: Parsons, Susan K.
502 $a Thesis (M.S.)--Sackler School of Graduate Biomedical Sciences (Tufts University), 2020.
506 $a This item must not be sold to any third party vendors.
520 $a Adjuvant hormone therapy (HT) with tamoxifen and aromatase inhibitors signiﬁcantly prolongs disease-free and overall survival time and is the recommended standard of care for women with early-stage breast cancer, yet suboptimal adherence is common. We aimed to further our understanding of patterns of HT use, speciﬁcally focusing on the prevalence and predictors of treatment interruptions (gaps exceeding 14 days but less than 180 days) and discontinuation (first gap exceeding 180 days) of HT. We identiﬁed 201 women who were diagnosed with stage I-III breast cancer between 2009-2015 and who initiated adjuvant HT, and were followed through December 31, 2016, at Tufts Medical Center. Of the 201 women with HR-positive tumors, 53 (26.4%) were initiated with a selective estrogen receptor modulator (SERM) and 148 (73.6%) with an aromatase inhibitor (AI). Median follow-up time was 3 years (IQR 1.5-4.5). During the follow-up period, 22 (10.9%) stopped taking prescribed HT with a median duration of 1.5 years (IQR 0.7-2.4), and 47 (23.4%) had at least one treatment interruption. Among those who ever had treatment interruption(s), 30 (63.8%) experienced the first treatment interruption within one year after HT initiation, and 13 (27.7%) eventually discontinued therapy. Regarding the pre-HT factors, results from adjusted Cox proportional hazards regression models indicated that women with pre-existing psycho-affective disorders were more likely to discontinue therapy (HR 3.15, 95%CI 1.35-7.37, P = 0.008); whereas pre-existing pain disorders were associated with earlier treatment interruption of HT (HR 2.24, 95%CI 1.20-4.19, P = 0.012). Mediation analysis found a statistically significant indirect effect of treatment interruption (0.052, 95%CI 0.007-0.10, P = 0.014) that accounted for 35.4% (95%CI 24-123%, P = 0.024) of the total effect of pre-existing psycho-affective disorders on early discontinuation, suggesting that a potential mediating role of treatment interruption in the relation between pre-existing psycho-affective disorders and early discontinuation. After HT initiation, HT-related symptoms were prevalent and the most common reason reported for interrupting or discontinuing therapy. Women who experienced severe treatment-related symptoms were at increased risk for both discontinuing therapy (HR 3.48, 95%CI 1.20-10.1, P = 0.022) and having earlier treatment interruption (HR 2.64, 95%CI 1.07-6.50, P = 0.035). In summary, treatment interruptions of HT were common and might be part of the causal pathway between pre-existing psycho-affective disorder and HT discontinuation. Both pre-existing disorders and HT-related symptoms may contribute to interrupted or discontinued therapy. Clinicians caring for breast cancer patients receiving HT should closely monitor their medication use and treatment-emergent symptoms, and encourage them to continue therapy through symptom management and patient-centered approaches.
590 $a School code: 0845.
650 4 $a Health sciences. $3 3168359
690 $a 0566
710 2 $a Sackler School of Graduate Biomedical Sciences (Tufts University). $b Clinical & Translational Science. $3 3541482
773 0 $t Masters Abstracts International $g 81-08.
790 $a 0845
791 $a M.S.
792 $a 2020
793 $a English
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=27545750