非小细胞肺癌患者术后辅助化疗依从性的影响因素分析

Analysis of influencing factors of postoperative adjuvant chemotherapy compliance in patients with nonsmall cell lung cancer

目的探讨非小细胞肺癌患者术后辅助化疗依从性的影响因素。方法收集2019年12月至2022年12月江苏省人民医院收治的非小细胞肺癌患者资料,采用回顾原始病历结合问卷调查的方式,资料收集不全者在护师问卷调查时予以补充。根据化疗依从性将患者分为依从性好组和依从性差组,分析化疗依从性的影响因素,同时汇总化疗依从性差患者的化疗中断原因及严重ADR发生情况。结果共纳入148例患者,依从性好组69例,依从性差组79例。单因素分析显示,两组患者的年龄、文化程度、病理类型、TNM分期、手术类型和家庭人均月收入比较,差异均有统计学意义(P<0.05);多因素logistic回归显示,年龄、文化程度、病理类型、TNM分期和手术类型是非小细胞肺癌患者化疗依从性的独立危险因素(P<0.05)。79例依从性差患者的化疗中断原因为严重不良反应41例、患者拒绝20例、未达到预期治疗效果14例、经济原因4例。结论年龄、文化程度、病理类型、TNM分期和手术类型是非小细胞肺癌患者化疗依从性的独立危险因素,临床应关注该类人群并积极干预,以减少不良反应发生,提高化疗依从性。

Objective To explore the influencing factors of postoperative adjuvant chemotherapy compliance in patients with non-small cell lung cancer(NSCLC).Methods The data of patients with NSCLC treated in Jiangsu Provincial People's Hospital from December 2019 to December 2022 were collected.The original medical records were reviewed and the ques⁃tionnaire was used to supplement the incomplete data collection.According to chemotherapy compliance,patients were divid⁃ed into a good compliance group and a poor compliance group,and the influencing factors of chemotherapy compliance were analyzed.At the same time,the causes of chemotherapy interruption and the occurrence of serious ADR in patients with poor chemotherapy compliance were summarized.Results A total of 148 patients were included,including 69 patients in the good compliance group and 79 patients in the poor compliance group.Univariate analysis showed that there were significant differ⁃ences in age,educational level,pathological type,TNM stage,surgery type and family per capita monthly income between the two groups(P<0.05).Multivariate logistic regression showed that age,education level,pathological type,TNM stage,and surgery type were independent risk factors for chemotherapy compliance in NSCLC patients(P<0.05).Among the 79 pa⁃tients with poor compliance,the reasons for chemotherapy interruption were serious adverse reactions in 41 cases,rejection in 20 cases,failure to achieve the expected therapeutic effect in 14 cases,and economic reasons in 4 cases.Conclusion Age,education level,pathological type,TNM stage,and surgery type are independent risk factors for chemotherapy compliance in patients with NSCLC.Clinical attention should be paid to this group of patients and active intervention should be conducted to reduce adverse reactions and improve chemotherapy compliance.