Late Effects of Radiation in Older Gynecologic Cancer Survivors

放射线对老年妇科癌症幸存者的后期影响

• 批准号: 8233766
• 负责人: Jean L Freeman
• 金额: $ 19.97万
• 依托单位: UNIVERSITY OF TEXAS MED BR GALVESTON
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-08 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8233766
• 关键词: Academic Medical Centers; Adverse effects; Adverse event; Aftercare; Algorithms; Area; Biological Models; Bladder; Cancer Patient; Cancer Survivor; Cardiac; Caring; Cervix Uteri; Characteristics; Clinical Trials; Code; Data; Databases; Decision Making; Diagnosis; Elderly; Endometrium; Evaluation; Health; Individual; Institution; Intestines; Late Effects; Life; Link; Long-Term Effects; Low income; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Malignant neoplasm of prostate; Medicare; Minority; Morbidity - disease rate; Newly Diagnosed; Patient Care; Patients; Physicians; Population; Primary Care Physician; Primary Health Care; Procedures; Protocols documentation; Provider; Radiation; Radiation Oncologist; Radiation therapy; Recording of previous events; Reporting; Research; Risk; Risk Estimate; Specialist; Surveillance Program; Survivors; Symptoms; Time; Toxic effect; Vagina; Variant; Vulva; base; cancer therapy; design; follow-up; gastrointestinal; malignant breast neoplasm; mortality; population based; study characteristics; survivorship; tumor; urinary

DESCRIPTION (provided by applicant): Cancer patients are living longer due to improvements in health and more effective cancer therapies. As a result, they are at increased risk for late effects of their initial treatment. Estimating and disseminating information on these potential risks is important for ongoing post treatment surveillance by primary care providers and cancer specialists. To date, risks of short and long term effects of cancer treatment have mainly been estimated from clinical trials and single institution studies. This information may not be applicable to large segments of the population who are under represented in research protocols, such as older, minority and low income cancer patients and patients treated outside academic medical centers. We propose to focus on gynecologic cancers as a model system for studying late effects of radiation using the SEER Medicare Database. The overall objectives of this research are to 1) construct and evaluate claims based algorithms for defining late effects of radiation related to bowel and bladder toxicities, 2) estimate the risks of these effects among older cancer survivors diagnosed from 1986- 2002 and 3) examine variations in the risk by patient, physician and facility characteristics, Study findings have important implications for two groups of older adults with personal histories of cancer. For newly diagnosed patients, our risk estimates over the most recent follow-up period (2000-2005) are helpful for making decisions about current treatment options. Information over the entire study period can also be used to develop individual Survivorship Plans - tailored to the survivor's personal characteristics and when she was treated - with recommended follow-up care. Such plans are critical for the effective surveillance of cancer survivors by primary care physicians, who provide much of the long term follow-up care for patients with these adverse effects. The plans can also remind and encourage survivors to report symptoms related to potential toxicities. PUBLIC HEALTH RELEVANCE: This study will estimate population-based risks of late urinary and gastrointestinal toxicity among older survivors of gynecologic cancers. The information is important for the design of post treatment cancer surveillance programs. Estimates of late toxicities are also helpful for newly diagnosed patients, as they make decisions about their treatment options.

描述（由申请人提供）：由于健康和更有效的癌症疗法的改善，癌症患者的寿命更长。结果，他们的初始治疗迟到的风险增加。估计和传播有关这些潜在风险的信息对于初级保健提供者和癌症专家正在进行的治疗后监视很重要。迄今为止，癌症治疗的短期和长期影响的风险主要是根据临床试验和单一机构研究估算的。该信息可能不适用于在研究方案中代表的大部分人群，例如老年人，少数和低收入癌症患者以及在学术医疗中心外接受治疗的患者。 我们建议将重点放在妇科癌症上，作为使用SEER Medicare数据库研究辐射的晚期影响的模型系统。这项研究的总体目标是1）构建和评估基于索赔的算法，以定义与肠和膀胱毒性相关的辐射的晚期作用，2）估计从1986- 2002年诊断为诊断为1986- 2002和3）研究这些影响的风险，研究了患者，身体和设施特征的风险，研究癌症对癌症的影响很重要。对于新诊断的患者，我们在最近的随访期（2000-2005）中的风险估计有助于做出有关当前治疗选择的决策。在整个研究期间，信息还可以用于制定个人生存计划 - 适合幸存者的个人特征以及接受治疗时 - 并推荐后续护理。此类计划对于初级保健医生对癌症幸存者的有效监视至关重要，后者为患有这些不良反应的患者提供了大部分长期随访护理。这些计划还可以提醒并鼓励幸存者报告与潜在毒性有关的症状。公共卫生相关性：这项研究将估计妇科癌症较老的幸存者的晚期尿和胃肠道毒性的风险。该信息对于治疗后癌症监测计划的设计很重要。晚期毒性的估计对新诊断的患者也有帮助，因为他们就治疗选择做出了决定。