Patterns of use of systemic chemotherapy for Medicare beneficiaries with urothelial bladder cancer
Patterns of use of systemic chemotherapy for Medicare beneficiaries with urothelial bladder cancer
复制标题
DOI：
10.1016/j.urolonc.2009.03.021
复制
发表时间：
2011-05-01
影响因子：
2.7
通讯作者：
Ramsey, Scott D.
中科院分区：
文献类型：
--
作者：
Porter, Michael P.;Kerrigan, Matthew C.;Ramsey, Scott D.
目的：检查临床、人口和社会经济因素与接受膀胱癌全身化疗之间的关联。检查影响膀胱癌联合化疗加膀胱切除术的使用以及随着时间的推移使用特定化疗药物的因素。材料和方法：分析了 SEER-Medicare 数据库中 1992 年至 2002 年间诊断为膀胱尿路上皮癌的患者的数据。使用 Cox 比例风险回归分析来评估基于人口和临床因素、护理地点和诊断年份的全身化疗使用的差异。我们评估了在辅助和新辅助治疗中接受化疗的患者比例以及在单一治疗中使用化疗的患者比例。我们按年份估算了门诊中几种常用化疗药物的索赔比例。结果：在随访期间，1 至 4 期患者分别有 13%、28%、37% 和 57% 接受了膀胱癌全身化疗。诊断后 6 个月内在新辅助或辅助治疗中使用化疗的情况并不常见。 1.4% 的 2 期患者和 11% 的 4 期患者接受了新辅助化疗。 2003 年，最常见的静脉化疗索赔是吉西他滨、卡铂和紫杉醇。结论：对于该患者群体中的浸润性膀胱癌患者，通常没有按照建议使用化疗。有必要进行研究来澄清潜在的未充分利用和管理模式的变化。 (C) 2011 Elsevier Inc. 保留所有权利。
Objectives: Examine the association between clinical, demographic, and socioeconomic factors and the receipt of systemic chemotherapy for bladder cancer. Examine factors influencing the use of combination chemotherapy plus cystectomy and use of specific chemotherapy drugs over time for bladder cancer.Materials and methods: Data from the SEER-Medicare database were analyzed for patients diagnosed with urothelial carcinoma of the bladder between 1992 and 2002. Cox proportional hazards regression analyses were used to assess differences in use of systemic chemotherapy based on demographic and clinical factors, site of care, and year of diagnosis. We assessed the proportion of patients who received chemotherapy in the adjuvant and neoadjuvant settings as well as use of chemotherapy in the monotherapy setting. We estimated the proportion of claims made for several commonly used chemotherapy agents in the outpatient setting by year.Results: During follow-up, 13%, 28%, 37%, and 57% of patients with stages 1 through 4, respectively, received systemic chemotherapy for bladder cancer. Chemotherapy use in the neoadjunvant or adjuvant settings within 6 months of diagnosis was not commonly found. Neoadjuvant chemotherapy was delivered to 1.4% Of stage 2 patients and 11% of stage 4 patients. In 2003, the most frequent claims for intravenous chemotherapy were for gemcitabine, carboplatin, and placlitaxel.Conclusions: Chemotherapy was not generally used as recommended for persons with invasive bladder cancer in this patient population. Studies to clarify potential underutilization and variation in patterns of;administration are warranted. (C) 2011 Elsevier Inc. All rights reserved.