Optimizing Treatment of Rectal Cancer Using a Markov Decision Model

这个项目提出了一个有指导的研究计划，将乔治·J·张医学博士发展成一个独立的 临床医生-科学家，专门从事与癌症相关的健康服务研究，汇集了癌症流行病学， 提高结直肠癌治疗效果的评价和临床决策分析 并预防和控制癌症治疗相关的MORB疾病。张医生是一位拥有双重董事会的外科医生 具有普通外科、结肠外科和直肠外科的证书，以及本学科的临床专业知识 求婚。职业发展计划包括教学教育，包括#年的理科硕士学位 临床研究，一个基础广泛的体验式学习计划，和一个有指导的研究经验， 指导研究将在由Scott B。 康托博士，M.D.安德森癌症中心生物统计学教授，美国癌症协会前主席 医学决策；乔恩·E·泰森，医学博士，M.P.H.，儿科学教授和医学研究中心主任 临床研究和循证医学，大学和德克萨斯健康科学中心； 福克斯·蔡斯癌症中心高级副总裁兼首席学术官、医学博士贝克将担任场外 导师和委员会成员。 建议的研究集中于通过开发毒性最小化和生活质量的应用癌症控制 保留治疗结肠癌患者的策略。直肠癌是人类的常见病。 目前的治疗是非常有效的，但可能与治疗相关的高毒性有关 具有显著的患者生活质量和社会成本。不幸的是，所有最近在传统临床上的尝试 基于美国国内调查的审判已经失败。拟议中的研究将使用公认的 先进的建模技术和患者偏好研究，以执行虚拟随机对照 确定毒性最小、临床最有效的治疗策略的临床试验 每年受这种常见癌症影响的患者。 相关性(请参阅说明)： 目前直肠癌的治疗策略没有考虑到诊断和治疗的进步，也没有考虑到 影响预后的与患者相关的各种差异。这项建议将有助于改善 直肠癌患者术前放化疗的选择 经历较少的慢性毒性，医生将有证据作为治疗的基础 建议，社会将减少与治疗和毒性相关的成本。

This project proposes a mentored research program todejvelop George J. Chang, M.D. into an independent clinician-scientist specializing in cancer-related health services research that brings together cancer epidemiology, outcomes evaluation, and clinical decision analysis in order to improve the treatment of colon and rectal cancer and to prevent and control cancer treatment related morb dities. Dr. Chang is a surgeon with dual board certifications in General Surgery and Colon and Rectal Sijrgery and a clinical expertise in the subject of this proposal. The career development plan consists of didactic education including a Master of Science degree in Clinical Research, a broad-based experiential learning program, and a mentored research experience, Mentored research will be conducted under the direction af the mentorship committee composed of Scott B. Cantor, Ph.D., Professor of Biostatistics at M. D. Anderson Cancer Center and past-president of the Society for Medical Decision Making; Jon E. Tyson, M.D., M.P.H., Professor of Pediatrics and Director of the Center for Clinical Research and Evidence-Based Medicine, Univers>ity of Texas Health Sciences Center; and J. Robert Beck, M.D., Senior Vice President and Chief Academic Officer, Fox Chase Cancer Center will serve as an off-site mentor and committee member. The proposed research focuses on applied cancer controI bydeveloping toxicity minimized and quality-of-life preserving strategies for the treatment of patients withrec;tal cancer. Rectal cancer is a common disease for which the current treatment is highly effective but can be associated with high rates of treatment-related toxicity with significant patient quality-of-life and societal costs.Unfortunately, all recent attempts at traditional clinical trials based on investigation within the United States have; failed. Theproposed research will use well-established advanced modeling techniques and patient preferences research to perform a virtual randomized controlled clinical trial to determine the least toxic and most clinicallyi effective treatment strategies orthetens ofthousands of patients affected by this common cancer each year. RELEVANCE (See instructions): Current treatment strategies for rectal cancer do not account for advances in diagnosis and treatment or for the wide variety of patient related differences that affect outcomes. This proposal will help improve the selection of patients with rectal cancer for preoperative chemoradiotherapy in order that patients will experience less chronic toxicity, physicians will have evidence on which to base treatment recommendations, and society will encumber fewer treatment and toxicity related costs.