Prevalence and threat of skeletal problems and use of radiation remedy in aged ladies identified with metastatic breast most cancers.
PLoS One. 2018;13(three):e0193661
Authors: Hussain A, Yong C, Tkaczuk KHR, Qian Y, Arellano J, Mullins CD, Onukwugha E
OBJECTIVE: Actual-world information relating to affected person components related to the incidence of spinal twine compression (SCC) or pathological fracture (PF), or want for bone surgical procedure (BS), or use of radiation remedy (RAD) (i.e. skeletal problems and radiation remedy; SCRT) are restricted for ladies with metastatic breast most cancers (BCa). Given the substantial scientific and financial burden of those occasions in superior BCa, we performed the current examine to know the prevalence and determine the chance components related to these occasions amongst aged ladies presenting with de novo metastatic BCa.
METHODS: Utilizing linked Surveillance, Epidemiology, and Finish Outcomes and Medicare information, we recognized ladies with incident metastatic BCa identified throughout 2005-2009. Associations between affected person demographics and choose clinically related components, and SCRT had been examined utilizing the Cox proportional hazards mannequin, accounting for loss of life as a competing threat.
RESULTS: Of three,731 Medicare beneficiaries with incident metastatic BCa, 1,808 (48.5%) skilled at the very least one SCRT occasion throughout a median follow-up of 13.2 months; a majority (69%) skilled a subsequent SCRT occasion. The proportions of girls who had RAD, PF, BS, and SCC had been: 32%, 28%, eight%, and four%. Older ladies (80+ years), or these with extra comorbid situations (CCI?2) had a statistically important decrease threat of SCRT (HR zero.78 [CI: 0.67-0.92, p<0.01]; HR zero.77 [CI: 0.67-0.89, p<0.01], respectively), primarily as a consequence of decrease frequency of radiotherapy (p<zero.01). In comparison with Caucasians, African People had decrease threat of SCRT (HR zero.70 [CI: 0.60-0.82, p<0.01]), in addition to all SCRT subtypes defining this group aside from SCC, which was the identical for each race teams.
CONCLUSION: This examine highlights that sure affected person traits and scientific components are related to the chance of spinal twine compression or pathologic fractures, or want for bone surgical procedure or radiation amongst ladies with metastatic BCa. In future research, it’ll even be necessary to contemplate the scientific and financial burden primarily based on these elements of skeletal problems and radiation remedy use in an effort to information and enhance the administration of girls with superior BCa.
PMID: 29494653 [PubMed – indexed for MEDLINE]