Comparison of 5-FU vs capecitabine in combination with mitomycin or cisplatin in the treatment of anal cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 3576-3576
Author(s):  
Irene Yu ◽  
Winson Y. Cheung
Keyword(s):  
Anal Cancer ◽  
Real World ◽  
Cancer Survival ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Operative Management ◽  
Population Based ◽  
Alternative Form ◽  
The Real ◽  
Treatment Groups

3576 Background: The patterns of capecitabine use as an alternative form of fluoropyrimidine to infusional 5-FU in the non-operative management of anal cancer in the real world are poorly described. Our objectives were to determine the frequency of capecitabine use, compare the observed outcomes between oral and intravenous fluoropyrimidines, and examine for variations in treatment-related adverse events between the two agents. Methods: All anal cancer patients who received either capecitabine or infusional 5-FU as part of their chemoradiation treatment from 2004 to 2013 at any 1 of 6 cancer centers in British Columbia were included. Chi-square and Wilcoxon-Mann tests were used to assess for associations between treatment groups and clinical characteristics and outcomes. Results: A total of 486 patients were identified: median age was 59 (IQR 53-67) years, 175 (36%) were men, 418 (86%) had ECOG 0/1, and 30 (6%) were HIV positive. Median total radiation dose was 54 cGy (IQR 50-54) and 47 (10%) underwent a colostomy prior to chemoradiation. Baseline characteristics were balanced between the two groups with respect to age, gender, ECOG, and HIV status (all p > 0.05). Prior to 2010, only 5-FU was utilized. From 2010 to 2013, 155 and 82 patients (65% vs 35%) received capecitabine vs 5-FU, respectively. Overall (68% vs 67%, p = 0.831) and disease-free survival rates (59% vs 59%, p = 0.926) at 3 years were similar in the capecitabine vs 5-FU groups. Rates of subsequent abdomino-perineal resection were also similar (10% vs 14%, p = 0.164). Patients who received 5-FU were more likely to report adverse effects (76% vs 57%, p < 0.01). The capecitabine group had a lower incidence of stomatitis (7% vs 43%, p < 0.01) whereas the 5-FU cohort reported less frequent hand-foot syndrome (1% vs 7%, p < 0.01). The rates of myelosuppression, nausea/vomiting, diarrhea, and rash were similar between the two groups (all p > 0.05). Conclusions: This represents one of the largest population-based studies to demonstrate a preference for capecitabine in place of 5-FU in the management of anal cancer. Survival outcomes were similar between the two treatment groups, but capecitabine may be better tolerated in the real world.

Comparison of 5-FU versus capecitabine in combination with mitomycin or cisplatin in the treatment of anal cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 680-680 ◽  
Author(s):  
Irene S. Yu ◽  
Winson Y. Cheung
Keyword(s):  
Anal Cancer ◽  
Cancer Survival ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Operative Management ◽  
Population Based ◽  
Chi Square ◽  
Curative Intent ◽  
Treatment Groups ◽  
The Difference

680 Background: Capecitabine is used as an alternative fluoropyrimidine to infusional 5-FU in the non-operative management of anal cancer due to its ease of administration. However, its patterns of use and long-term outcomes in the real world are poorly described. Our objectives were to determine the frequency of capecitabine use, compare the difference in outcomes, and examine the difference in treatment-related adverse events between oral and intravenous fluoropyrimidines. Methods: All anal cancer patients who received either capecitabine or infusional 5-FU as part of their curative intent chemoradiotherapy from 2010 to 2013 at any 1 of 6 comprehensive cancer centers in British Columbia were included. Chi-square and Wilcoxon-Mann tests were used to assess for associations between treatment groups and clinical characteristics and outcomes. Results: A total of 237 patients were identified; median age was 59 (IQR 53-67) years, 71 (30%) were men, 202 (85%) had ECOG 0/1, and 12 (5%) were HIV positive. Median total radiation dose was 54 cGy (IQR 50.4-54.0) and 21 (9%) underwent a colostomy prior to chemoradiation. Baseline characteristics were balanced between the two groups with respect to age, gender, ECOG, and HIV status (all p > 0.05). Overall, 155 patients (65%) received capecitabine. Comparing patients who received capecitabine vs 5-FU, overall (69% vs 74%, p = 0.388) and disease-free survival rates (68% vs 71%, p = 0.637) at 5 years from diagnosis were similar between treatment groups. There were no differences with respect to rates of subsequent colostomy (16% vs 23%, p = 0.185) and abdominoperineal resection (11% vs 12%, p = 0.777). However, patients who received capecitabine were less likely to report adverse effects (51% vs 26%, p < 0.001) than those who underwent 5-FU. The capecitabine group had a lower incidence of stomatitis (6% vs 40%, p < 0.001) whereas the 5-FU cohort reported less frequent hand-foot syndrome (1% vs 8%, p = 0.036). Conclusions: This population-based study demonstrates a preference for capecitabine use in place of 5-FU in the curative management of anal cancer. Survival outcomes are similar between the two treatment groups, but capecitabine may be better tolerated.

scholarly journals Breast Cancer Survival in the Mammography Era in Brazil: A Population-Based Analysis of 2,715 Cases

2021 ◽  
Author(s):  
Juliana Fernandes ◽  
Beatriz Machado ◽  
Cassio Cardoso-Filho ◽  
Juliana Nativio ◽  
Cesar Cabello ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survival ◽  
Survival Rates ◽  
Population Based ◽  
Breast Cancer Survival ◽  
Stage I ◽  
Current Status ◽  
Breast Cancers ◽  
Risk Of Death ◽  
Significant Difference

Abstract Background This study aims to assess breast cancer survival rates after one decade of mammography in a large urban area of Brazil. Methods It is a population-based retrospective cohort of women with breast cancer in Campinas, São Paulo, from 2010 to 2014. Age, vital status and stage were accessed through the cancer and mortality registry, and patients records. Statistics used Kaplan-Meier, log-rank and Cox's regression. Results Out of the 2,715 cases, 665 deaths (24.5%) were confirmed until early 2020. The mean age at diagnosis was 58.6 years. Women 50-69 years were 48.0%, and stage I the most frequent (25.0%). The overall mean survival was 8.4 years (8.2-8.5). The 5-year survival (5yOS) for overall, 40-49, 50-59, 60-69, 70-79 years was respectively 80.5%, 87.7%, 83.7%, 83.8% and 75.5%. The 5yOS for stages 0, I, II, III and IV was 95.2%, 92.6%, 89.4%, 71.1% and 47.1%. There was no significant difference in survival in stage I or II (p=0.058). Compared to women 50-59 years, death's risk was 2.3 times higher for women 70-79 years and 26% lower for women 40-49 years. Concerning stage I, the risk of death was 1.5, 4.1 and 8.6 times higher, and 34% lower, respectively, for stage II, III, IV and 0. Conclusions In Brazil, breast cancers are currently diagnosed in the early stages, although advanced cases persist. Survival rates may reflect improvements in screening, early detection and treatment. The results can reflect the current status of other regions or countries with similar health care conditions.

scholarly journals Improvement in childhood cancer survival in Lithuania over three decades

2020 ◽  
Vol 27 (1) ◽  
pp. 1-9
Author(s):  
Jelena Rascon ◽  
Giedrė Smailytė
Keyword(s):  
Childhood Cancer ◽  
Cancer Survival ◽  
Survival Rates ◽  
Population Based ◽  
Early Years ◽  
University Hospital ◽  
Entire Cohort ◽  
Background Population ◽  
Childhood Cancer Survival

Background. Population-based EUROCARE-5 studies demonstrated that childhood cancer survival rates in Lithuania were 10–20% lower than the European mean. We aimed to analyse the change in the outcome of treatment of paediatric malignancies in Lithuania over 30 years. Methods. A single-centre retrospective analysis of children below 18 years of age treated for cancer at Vilnius University Hospital Santaros Klinikos between 1982 and 2011 was carried out. The minimal requirement of 5-year follow-up after diagnosis was specified for survival estimation. The vital status was assessed using data from the population-based Lithuanian Cancer Registry. To evaluate changes over time, the entire cohort was split into three groups according to the time of diagnosis: 1982–1991, 1992–2001, and 2002–2011. Results. A total of 1268 children met the inclusion criteria. The shortest median follow-up was 8.9 (IQR 6.4–11.5) years for patients treated in the third decade. The 5-year overall survival of the entire cohort increased from 37.3% (95% CI 30.2–44.3) in 1982–1991 to 70.7% (95% CI 66.4–74.1) in 2002–2011 (p < 0.0001). The same trend was evident when calculated separately for leukaemia (p < 0.0001), lymphoma (p < 0.0005), and solid tumours (p < 0.004). The percentage of cure rose from zero in the early years of the period analysed to 80% in 2010 and 2011. The improvement in the treatment outcome was attributable to the reduction of treatment-related mortality from 45.8% in 1982–1991 to 12.4% in 2002–2011 and disease recurrence from 30.4% to 19.6% for the same periods, respectively. Conclusions. Significant progress in the cure rate of children treated for cancer at our institution was observed over 30 years. Collaborative national and international clinical and research efforts are crucial to ensure further advances in care and cure.

scholarly journals Outcomes of Hypofractionated Versus Standard Fractionated Breast Cancer Radiation in the Real World: A Population-Based Analysis

2015 ◽  
Vol 93 (3) ◽  
pp. E40-E41
Author(s):  
L. Hwang ◽  
I.J. Boero ◽  
D.P. Triplett ◽  
R.K. Matsuno ◽  
B. Xu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Real World ◽  
Population Based ◽  
The Real

Value of precision medicine in advanced NSCLC: Real-world outcomes associated with the use of companion diagnostics.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e20015-e20015
Author(s):  
Ani John ◽  
Roma Shah ◽  
William Bruce Wong ◽  
Charles Schneider ◽  
Hamid H. Gari ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Real World ◽  
Proportional Hazards ◽  
Survival Rates ◽  
Prognostic Index ◽  
Cox Proportional Hazards ◽  
Advanced Stage ◽  
Clinical Value ◽  
The Real

e20015 Background: Five-year survival rates as low as 2.8% have been reported in patients with non-small cell lung cancer (NSCLC), highlighting the need for individualized diagnosis and treatment. Companion diagnostic testing (CDx) identifies patients with molecular targets likely to respond better to particular therapies; however, not all cancer patients receive CDx in the real-world setting. This study evaluated the clinical value of CDx in the real world with respect to overall survival among patients with non-squamous advanced (Stage IIIB/IV) NSCLC (aNSCLC). Methods: Patients were from the Flatiron Health electronic health-derived database, treated with systemic therapy, and diagnosed with aNSCLC between January 1, 2011 and May 31, 2018; those who received CDx with their first line of treatment were compared with those who did not. Logistic regression using components of the modified Lung Cancer Prognostic Index (LCPI; age, sex, stage, actionable mutation(s), smoking, respiratory comorbidity; Alexander et al. Br J Cancer. 2017) and other factors were used to predict characteristics associated with receiving CDx. Overall survival was evaluated using Kaplan-Meier analysis. Unadjusted and adjusted Cox proportional hazards regression models were used to evaluate the association between CDx and overall survival. Results: A total of 17,143 patients with aNSCLC (CDx, n = 14,389; no CDx, n = 2754) and a mean (SD) age at diagnosis of 67.2 (10.0) years (CDx, 67.1 [10.1]; no CDx, 67.5 [9.2]) were included. There were more nonsmokers in the CDx group (17.4%) than the no CDx group (5.5%). Patients who were female, diagnosed after 2014, receiving multiple lines of therapy or had advanced stage at diagnosis were more likely to receive CDx. Patients receiving CDx had decreased mortality risk (unadjusted HR [95% CI] = 0.54 [0.52-0.57]) and lived longer than those not receiving CDx (median survival = 14 vs 7 months). The significant reduction in mortality associated with CDx remained after adjusting for factors included in the modified LCPI (adjusted HR [95% CI] = 0.78 [0.75-0.82]) as well as a model without actionable mutations (adjusted HR [95% CI] = 0.70 [0.66-0.73]). Conclusions: Among patients with non-squamous aNSCLC, use of CDx was associated with reduced risk of mortality compared with no CDx.

Comparing Cardiovascular Safety of Febuxostat and Allopurinol in the Real World: A Population-Based Cohort Study

2019 ◽  
Vol 94 (7) ◽  
pp. 1147-1157 ◽  
Author(s):  
Ching-Yen Su ◽  
Li-Jiuan Shen ◽  
Song-Chou Hsieh ◽  
Lian-Yu Lin ◽  
Fang-Ju Lin
Keyword(s):  
Cohort Study ◽  
Real World ◽  
Population Based ◽  
Cardiovascular Safety ◽  
The Real

Use of granulocyte colony stimulating factor (GCSF) in patients receiving highly myelosuppressive chemotherapy for breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21677-e21677 ◽  
Author(s):  
Emily Kornelsen ◽  
Winson Y. Cheung
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Real World ◽  
Regression Models ◽  
Population Based ◽  
Neutropenic Fever ◽  
Poor Performance Status ◽  
Breast Cancer Patients ◽  
Myelosuppressive Chemotherapy ◽  
The Real

e21677 Background:We hypothesized that GCSF use may be suboptimal in the real world despite prior research that shows prophylaxis with GCSF can reduce neutropenic fevers and hospitalizations. Our aims were to characterize patterns of GCSF use in a population-based cohort of breast cancer patients receiving highly myelosuppressive chemotherapy and to describe outcomes and predictors associated with appropriate GCSF prophylaxis. Methods:Patients diagnosed with breast cancer from 2008 to 2012, seen at any 1 of 5 comprehensive cancer centers in a Canadian province, and treated with chemotherapy that posed > 20% risk of neutropenic fever were reviewed. Associations between GCSF use and 1) patient and physician factors and 2) treatment outcomes, including rate of neutropenic fevers, were analyzed using regression models. Results:We included 805 women: median age was 52 (IQR 44 to 61) years, 40% reported smoking, 52% used alcohol regularly, 64% were ECOG 0, and 24% had private health insurance. In this cohort, 330 (41%) patients were given GCSF. Among those treated with GCSF, 132 (40%) and 198 (60%) individuals received GCSF as primary and secondary prophylaxis, respectively. Overall, neutropenia was noted in 467 (58%) cases while neutropenic fever was experienced by 161 (20%) patients. When compared to those who did not use GCSF, patients who used GCSF experienced a lower rate of neutropenia (14% vs. 61%, p < 0.01) and a decreased incidence of neutropenic fever (8% vs. 23%, p < 0.01). In regression models, patients lacking extended medical coverage (32% vs. 49%, p = 0.02), poor performance status (30% vs. 55%, p = 0.03), and those who were evaluated at non-teaching institutions (25% vs. 69% p < 0.01) were less likely to receive GCSF. Patients seen at non-teaching institutions were also given primary GCSF prophylaxis less frequently (16% vs 59%, p < 0.01) than those at teaching centers. Conclusions:GCSF prophylaxis was associated with improved neutropenia-related outcomes in the real world. Despite evidence-based recommendations, use of GCSF remains suboptimal in this population-based cohort of breast cancer patients receiving highly myelosuppressive chemotherapy.

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