scholarly journals Treatment trends and Medicare reimbursements for localized prostate cancer in elderly patients

2018 ◽  
Vol 12 (7) ◽  
pp. E338-44 ◽  
Author(s):  
Paolo Dell'Oglio ◽  
Anne Sophie Valiquette ◽  
Sami-Ramzi Leyh-Bannurah ◽  
Zhe Tian ◽  
Vincent Trudeau ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Elderly Patients ◽  
Treatment Modality ◽  
Localized Prostate Cancer ◽  
Treatment Modalities ◽  
Median Cost ◽  
Cumulative Cost ◽  
Treatment Trends ◽  
Dominant Treatment

Introduction: The absolute and proportional numbers of elderly patients diagnosed with localized prostate cancer (PCa) are on the rise. We examined treatment trends and reimbursement figures in localized PCa patients aged ≥80 years.Methods: Between 2000 and 2008, we identified 30 217 localized PCa patients aged ≥80 years in Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database. Alternative treatment modalities consisted of conservative management (CM), radiation therapy (RT), radical prostatectomy (RP), and primary androgendeprivation therapy (PADT). For all four modalities, utilization and reimbursements were examined.Results: PADT was the most frequently used treatment modality between 2000 and 2005. CM became the dominant treatment modality from 2006‒2008. RP rates were marginal. RT ranked third, and its annual rate increased from 20.77% in 2000 to 29.13% in 2008. Median individual reimbursement of RT was highest and ranged from $29 343 in 2000 to $31 090 in 2008, followed by RP (from $20 560 in 2000 to $19 580 in 2008), PADT (from $18 901 in 2000 to $8000 in 2008), and CM (from $1824 in 2000 to $1938 in 2008). RT contributed to most of the cumulative annual reimbursements from 2003 (49.24%) to 2008 (72.97%). PADT ranked first from 2000 (54.56%) to 2002 (50.49%), but decreased by 19.40% in 2008. CM’s contribution increased from 4.42% in 2000 to 6.96% in 2008. RP’s share of reimbursements was stable during the study period.Conclusions: Our results, focusing on localized PCa treatment in patients aged ≥80 years, showed an important increase in rates, median cost, and proportion of cumulative cost related to RT.

Localized Prostate Cancer in Elderly Patients Outcome after Radiation Therapy Compared to Matched Younger Patients

1999 ◽  
Vol 175 (11) ◽  
pp. 554-558 ◽  
Author(s):  
Pia U. Huguenin ◽  
Marc Bitterli ◽  
Urs M. Lütolf ◽  
Jürg Bernhard ◽  
Christoph Glanzmann
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Elderly Patients ◽  
Localized Prostate Cancer ◽  
Younger Patients

SOCIO-PSYCHOLOGICAL ASPECTS OF THE QUALITY OF LIFE OF ELDERLY PATIENTS WITH PROSTATE CANCER AFTER RADIATION THERAPY

2017 ◽  
Vol 63 (5) ◽  
pp. 776-779
Author(s):  
Galina Tkachenko ◽  
Irina Gladilina ◽  
Aleksandra Stepanova ◽  
Anna Potapova ◽  
Anatoliy Antonov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radiation Therapy ◽  
Elderly Patients ◽  
Leisure Time ◽  
Psychological Aspects ◽  
Sexual Relations ◽  
Health Satisfaction ◽  
Material Conditions

The paper presents results of clinical and psychological studies of the quality of life of elderly patients with prostate cancer following radiation therapy. Socio-psychological aspects of the quality of life were assessed using a modified scale of self-evaluation of Dembo-Rubinstein. In 3-6 months after radiation therapy there was noted significant reduction, compared to the beginning of treatment, on scales: «satisfaction with communication», «satisfaction with health», «satisfaction material conditions», «satisfaction with sexual relations», «satisfaction with activity», «satisfaction with leisure time and rest». Average indices of scales «satisfaction with health», «satisfaction with sexual relations», «satisfaction with leisure time and rest» fell below the middle. At the same time patients were not depressed by their situation did not fixed on thoughts about the disease, on the contrary the mood was significantly higher compared to the initial course of radiotherapy that could be associated with the psychological characteristics of the age of the patients in our sample.

scholarly journals Radiation therapy dose and androgen deprivation therapy in localized prostate cancer: a meta-regression of 5-year outcomes in phase III randomized controlled trials

2021 ◽  
Author(s):  
Tommy Jiang ◽  
Daniela Markovic ◽  
Jay Patel ◽  
Jesus E. Juarez ◽  
Ting Martin Ma ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Androgen Deprivation Therapy ◽  
Dose Escalation ◽  
Low Dose ◽  
Androgen Deprivation ◽  
Phase Iii ◽  
Localized Prostate Cancer ◽  
Treatment Intensification ◽  
Meta Regression

Abstract Background While multiple randomized trials have evaluated the benefit of radiation therapy (RT) dose escalation and the use and prolongation of androgen deprivation therapy (ADT) in the treatment of prostate cancer, few studies have evaluated the relative benefit of either form of treatment intensification with each other. Many trials have included treatment strategies that incorporate either high or low dose RT, or short-term or long-term ADT (STADT or LTADT), in one or more trial arms. We sought to compare different forms of treatment intensification of RT in the context of localized prostate cancer. Methods Using preferred reporting items for systemic reviews and meta-analyses (PRISMA) guidelines, we collected over 40 phases III clinical trials comparing different forms of RT for localized prostate cancer. We performed a meta-regression of 40 individual trials with 21,429 total patients to allow a comparison of the rates and cumulative proportions of 5-year overall survival (OS), prostate cancer-specific mortality (PCSM), and distant metastasis (DM) for each treatment arm of every trial. Results Dose-escalation either in the absence or presence of STADT failed to significantly improve any 5-year outcome. In contrast, adding LTADT to low dose RT significantly improved 5-year PCSM (Odds ratio [OR] 0.34, 95% confidence interval [CI] 0.22–0.54, p < 0.001) and DM (OR 0.35, 95% CI 0.20–0.63. p < 0.001) over low dose RT alone. Adding STADT also significantly improved 5-year PCSM over low dose RT alone (OR 0.55, 95% CI 0.41–0.75, p < 0.001). Conclusion While limited by between-study heterogeneity and a lack of individual patient data, this meta-analysis suggests that adding ADT, versus increasing RT dose alone, offers a more consistent improvement in clinical endpoints.

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