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2016年7月25日，美国临床肿瘤学会官方期刊《临床肿瘤学杂志》在线发表圣迭戈州立大学、圣迭戈加利福尼亚大学（加利福尼亚大学圣迭戈分校）穆尔斯癌症中心的系统回顾，评估了患者引导对乳腺癌的治疗与生存是否有效。 患者引导（又译：导航、领航、导医、导诊）是一种通过减少障碍和促进及时获得癌症诊疗以改善癌症结局的干预方法，其在乳腺癌治疗和生存期间的好处尚不明确。该系统回顾评估了患者引导对乳腺癌女性提高治疗和生存结局的的效果，包括针对乳腺癌治疗和乳腺癌生存的患者引导方案实验性和准实验性研究，通过检索PubMed/MEDLINE、PsycINFO、Web of Science、CINAHL、Cochrane Library电子数据库系统性获取文献，使用“有效公共卫生实践项目质量评定工具”评估各个研究的方法学质量。 结果共有13项研究符合入选标准，大多数质量中到高。有针对性的结局包括治疗启动时效性、癌症治疗依从性、治疗后监测乳腺钼靶检查依从性。结果评定异质性妨碍了荟萃分析。总体上，结果表明患者引导增加了监测乳腺钼靶检查率，但仅找到很少证据支持其对于改善乳腺癌治疗结局的有效性。 该研究对于关注提高乳腺癌治疗和生存的患者引导研究是最全面的系统回顾。最小研究表明患者引导对于治疗后监测可能有效，但是需要更多研究才能对患者引导在癌症治疗期间和之后的效果得出明确结论。 J Clin Oncol. 2016 Jul 25. [Epub ahead of print] Patient Navigation in Breast Cancer Treatment and Survivorship: A Systematic Review. Sharon H. Baik, Linda C. Gallo, Kristen J. Wells. San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology; San Diego State University; University of California San Diego Moores Cancer Center, San Diego, CA. PURPOSE: Patient navigation is an intervention approach that improves cancer outcomes by reducing barriers and facilitating timely access to cancer care. Little is known about the benefits of patient navigation during breast cancer treatment and survivorship. This systematic review evaluates the efficacy of patient navigation in improving treatment and survivorship outcomes in women with breast cancer. METHODS: The review included experimental and quasi-experimental studies of patient navigation programs that target breast cancer treatment and breast cancer survivorship. Articles were systematically obtained through electronic database searches of PubMed/MEDLINE, PsycINFO, Web of Science, CINAHL, and Cochrane Library. The Effective Public Health Practice Project Quality Assessment Tool was used to evaluate the methodologic quality of individual studies. RESULTS: Thirteen studies met the inclusion criteria. Most were of moderate to high quality. Outcomes targeted included timeliness of treatment initiation, adherence to cancer treatment, and adherence to post-treatment surveillance mammography. Heterogeneity of outcome assessments precluded a meta-analysis. Overall, results demonstrated that patient navigation increases surveillance mammography rates, but only minimal evidence was found with regard to its effectiveness in improving breast cancer treatment outcomes. CONCLUSION: This study is the most comprehensive systematic review of patient navigation research focused on improving breast cancer treatment and survivorship. Minimal research has indicated that patient navigation may be effective for post-treatment surveillance; however, more studies are needed to draw definitive conclusions about the efficacy of patient navigation during and after cancer treatment. DOI: 10.1200/JCO.2016.67.5454
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