| Summary: | 碩士 === 長庚大學 === 醫務管理學系 === 101 === According to the 2010 statistics of Department of Health, malignant neoplasm remained as the highest ranking in the top ten leading causes of death in Taiwan. Specifically, breast cancer accounts for the most cancer incidence in females in Western Europe, Northern American, and Taiwan. It is important to investigate the risk factors affecting the survival rate of breast cancer to reduce the threats of breast cancer to women's health.
The treatment of breast cancer includes surgery, chemotherapy, hormone blocking therapy, and radiotherapy. The prognosis and survival rates is found to be positively correlated with the integrity of treatment packages. An interruption of the treatment protocols may reduce treatment efficiency, aversely affects the recovery, increases the chance of relapse or metastasization. The cancer cells can also become drug resistant. This research was designed to investigate the relating factors of breast cancer survivals as well as the correlations between the survival rate and the decisions of cancer patients to continue / discontinue current treatment protocol. The result will provide insights to the clinical care of breast cancer patients by improving the survival rates and care quality of the breast cancer patients.
This research used 3,586 breast cancer patient data collected between 2006 and 2011 from a case management information system of a medical center located in Northern Taiwan. The data was analyzed by SPSS 18.0. The survival analysis (Cox Regression) was used to establish the survival model in comparison of continuity and discontinuity groups. The result showed that the dominant factors of breast cancer survivals include age, hormone blocking therapy, radiotherapy, relapse, anamnesis, and the cancer stages. In terms of the effect of treatment continuity on cancer survival, after other variables were controlled, the death risk of discontinuing treatment was found to be 1.984 times more than continuing treatment which is statistically significant.
This research suggests that case managers to provide more resources to the high-risk patients, such as those with elder age, having previous history on cancer, relapsers, and patients with diagnosis of the first or third cancer stages. In addition, hormone blocking therapy and radiotherapy can be incorporated into treatments after careful evaluations of clinical evidences. Since the continuity of treatment has a significant effect, the cancer treatment institutes are suggested to opt for a patient-centered scope by establishing inter-hospital transfer mechanisms to enhance the follow-ups on patient treatments.
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