scholarly journals PCN31 DIRECT MEDICAL COSTS OF ELDERLY PATIENTS WITH STAGE III COLON CANCER DURING FIRST-LINE VERSUS SECOND-LINE CHEMOTHERAPY

2011 ◽  
Vol 14 (3) ◽  
pp. A160
Author(s):  
H.K. Yang ◽  
K. Bikov ◽  
E. Onukwugha ◽  
C.D. Mullins
Keyword(s):  
Colon Cancer ◽  
Elderly Patients ◽  
Medical Costs ◽  
Stage Iii ◽  
Second Line ◽  
First Line ◽  
Second Line Chemotherapy ◽  
Stage Iii Colon Cancer ◽  
Direct Medical Costs ◽  
Line Chemotherapy

scholarly journals Impact on Medical Cost, Cumulative Survival, and Cost-Effectiveness of Adding Rituximab to First-Line Chemotherapy for Follicular Lymphoma in Elderly Patients: An Observational Cohort Study Based on SEER-Medicare

2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
Robert I. Griffiths ◽  
Michelle L. Gleeson ◽  
Joseph Mikhael ◽  
Mark D. Danese
Keyword(s):  
Cost Effectiveness ◽  
Elderly Patients ◽  
Follicular Lymphoma ◽  
The Elderly ◽  
Medical Costs ◽  
Routine Practice ◽  
First Line ◽  
Cumulative Survival ◽  
Direct Medical Costs ◽  
Line Chemotherapy

Rituximab improves survival in follicular lymphoma (FL), but is considerably more expensive than conventional chemotherapy. We estimated the total direct medical costs, cumulative survival, and cost-effectiveness of adding rituximab to first-line chemotherapy for FL, based on a single source of data representing routine practice in the elderly. Using surveillance, epidemiology, and end results (SEER) registry data plus Medicare claims, we identified 1,117 FL patients who received first-line CHOP (cyclophosphamide (C), doxorubicin, vincristine (V), and prednisone (P)) or CVP +/−rituximab. Multivariate regression was used to estimate adjusted cumulative cost and survival differences between the two groups over four years after beginning treatment. The median age was 73 years (minimum 66 years), 56% had stage III-IV disease, and 67% received rituximab. Adding rituximab to first-line chemotherapy was associated with higher adjusted incremental total cost ($18,695; 95% Confidence Interval (CI) $9,302–$28,643) and longer adjusted cumulative survival (0.18 years; 95% CI 0.10–0.27) over four years of followup. The expected cost-effectiveness was $102,142 (95% CI $34,531–296,337) per life-year gained. In routine clinical practice, adding rituximab to first-line chemotherapy for elderly patients with FL results in higher direct medical costs to Medicare and longer cumulative survival after four years.

scholarly journals Does the type of first-line regimens influence the receipt of second-line chemotherapy treatment? An analysis of 3211 metastatic colon cancer patients

2014 ◽  
Vol 3 (1) ◽  
pp. 124-133 ◽  
Author(s):  
Zhiyuan Zheng ◽  
Nader Hanna ◽  
Eberechukwu Onukwugha ◽  
Emily S. Reese ◽  
Brian Seal ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Patients ◽  
Metastatic Colon Cancer ◽  
Second Line ◽  
Chemotherapy Treatment ◽  
First Line ◽  
Second Line Chemotherapy ◽  
Line Chemotherapy

scholarly journals Management of neuroblastoma: a study of first- and second-line chemotherapy responses, a single institution experience

2012 ◽  
Vol 6 (1) ◽  
pp. 3 ◽  
Author(s):  
Emmad E. Habib ◽  
Amr T. El-Kashef ◽  
Ezzat S. Fahmy
Keyword(s):  
External Beam Radiotherapy ◽  
Second Line ◽  
First Line ◽  
Actuarial Survival ◽  
Term Survival ◽  
Second Line Chemotherapy ◽  
Significant Difference ◽  
Grade Malignancy ◽  
Chemotherapy Patients ◽  
Line Chemotherapy

Neuroblastoma is a high-grade malignancy of childhood. It is chemo- and radio-sensitive but prone to relapse after initial remission. The aim of the current study was to study the results of the first- and second-line chemotherapy on the short-term response and long-term survival of children, and to further describe the side effects of treatment. Ninety-five children with advanced neuroblastoma were included in the study, divided into two groups according to the treatment strategy: 65 were treated by first-line chemotherapy alone, and 30 children who were not responding or relapsed after first-line chemotherapy were treated by second-line chemotherapy. External beam radiotherapy was given to bone and brain secondary cancers when detected. Staging workup was performed before, during and after management. Response was documented after surgery for the primary tumor. Median follow up was 32 months (range 24-60 months). Chemothe rapy was continued until toxicity or disease progression occurred, indicating interruption of chemotherapy. Patients received a maximum of 8 cycles. Toxicity was mainly myelo-suppression, with grade II-III severity in 60% of the firstline and 70% of the second-line chemotherapy patients. Median total actuarial survival was nearly 51 months for the first-line chemotherapy group and 30 months for the second-line line group, with a statistically significant difference between the two groups (P<0.01).

Elevation of Neutrophil-to-Lymphocyte Ratio before First-Line Chemotherapy Predicts a Poor Prognosis for Second-Line Chemotherapy in Gastric Cancer

Oncology ◽  
2018 ◽  
Vol 96 (3) ◽  
pp. 140-146 ◽  
Author(s):  
Dai Inoue ◽  
Shuhei Sekiguchi ◽  
Wataru Yamagata ◽  
Gen Maeda ◽  
Daiki Yamada ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Poor Prognosis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Second Line ◽  
First Line ◽  
Lymphocyte Ratio ◽  
Second Line Chemotherapy ◽  
Line Chemotherapy

scholarly journals Decreasing Use of Chemotherapy in Older Patients With Stage III Colon Cancer Irrespective of Comorbidities

2019 ◽  
Vol 17 (9) ◽  
pp. 1089-1099 ◽  
Author(s):  
Viola Walter ◽  
Daniel Boakye ◽  
Janick Weberpals ◽  
Lina Jansen ◽  
Walter E. Haefeli ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Elderly Patients ◽  
Old Age ◽  
Population Based ◽  
Stage Iii ◽  
Stage Iii Colon Cancer ◽  
Patient Interviews ◽  
Chemotherapy Administration ◽  
Hospital Factors ◽  
Chemotherapeutic Treatment

Background: Chemotherapy underuse in elderly patients (aged ≥75 years) with colon cancer has been reported in previous studies. However, these studies were mostly registry-based and limited in their potential to consider underlying reasons of such undertreatment. This study aimed to evaluate patient and hospital determinants of chemotherapeutic treatment in patients with stage III colon cancer, with a particular focus on age and underlying reasons for nontreatment of elderly patients. Methods: A total of 629 patients with stage III colon cancer who were diagnosed in 2003 through 2012 and recruited into a population-based study in the Rhine-Neckar region of Germany were included. Information on sociodemographic and lifestyle factors, comorbidities, and treatment was collected from patient interviews and physicians. Patient (with an emphasis on age) and hospital factors were evaluated for their associations with administration of adjuvant chemotherapy overall and of oxaliplatin specifically using multivariable logistic regression. Results: Administration of chemotherapy decreased from 94% in patients aged 30 to 64 years to 51% in those aged ≥75 years. A very strong decline in chemotherapy use with age persisted even after comprehensive adjustment for multiple patient factors—including comorbidities—and hospital factors and was also seen among patients without any major comorbidities. Between 2005 and 2008, and 2009 and 2012, chemotherapy administration in patients aged ≥75 years decreased from 60% to 41%. Among chemotherapy recipients, old age was also strongly associated with higher odds of nonadministration of oxaliplatin. The 2 most commonly reported reasons for chemotherapy nonreceipt among the study population were patient refusal (30%) and old age (24%). Conclusions: Age was the strongest predictor of chemotherapy underuse, irrespective of comorbidities and even in patients without comorbidities. Such underuse due just to older age in otherwise healthy patients deserves increased attention in clinical practice to ensure that elderly patients also get the best possible care. Patients’ refusal as the most frequent reason for chemotherapy nonreceipt also warrants further investigation to exclude misinformation as underlying cause.

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