关键词: 非小细胞肺癌, 广义估计方程, 治疗质量评价, 影响因素分析

Abstract: Objective The objective of this study was to analyze the influencing factors of treatment quality in patients with non-small cell lung cancer(NSCLC)based on generalized estimating equations(GEE),and to provide evidence for improving the treatment quality of NSCLC patients. Methods Medical record data of NSCLC patients from Harbin Medical University Cancer Hospital from 2010 to 2021 were collected.Based on the evaluation index system for NSCLC treatment quality previously constructed by our research team,16 evaluation indicators for NSCLC treatment quality were selected to calculate the comprehensive score of patients.Patients were divided into high-and low-quality groups based on the median comprehensive score.Baseline characteristics of patients were used as independent variables,and the treatment quality groups were used as dependent variables.The GEE method was used to analyze the influencing factors of treatment quality in NSCLC patients. Results A total of 4,234 NSCLC patients were included in the study.The median comprehensive score of patients was 0.428 5(0.333 3,0.571 4),with 2,321 patients in the high-quality group(≥0.428 5)and 1,913 patients in the low-quality group(＜0.428 5).There were significant differences in hospitalization duration and payment method between the two groups(P＜0.05).The results of the generalized estimating equation analysis showed that patient age,body mass index(BMI),payment method,and lung cancer stage had a statistically significant effects on the comprehensive score of treatment quality(P＜0.05).Patients with lower BMI and those over 60 years old had poorer treatment quality,while patients in the early stages of lung cancer and those paying fully out of pocket had better treatment quality.Patients with poorer treatment quality had lower completion rates for electrocardiogram examination,radical resection rates in early-stage patients,and utilization rates of standardized chemotherapy indicators. Conclusion Individualized treatment plans should be developed for patients over 60 years old,those with low BMI,and patients with advanced lung cancer during the treatment process of NSCLC;Early screening and treatment are recommended to improve the treatment quality for NSCLC patients.

Key words: non-small cell lung cancer, generalized estimating equations, treatment quality assessment, influencing factor analysis