schliessen

Filtern

 

Bibliotheken

Decision framework for chemotherapeutic interventions for metastatic non-small-cell lung cancer.

BACKGROUNDBest supportive care has long been considered to be the standard therapy for metastatic non-small-cell lung cancer (NSCLC). There is now evidence from randomized trials that a number of chemotherapy regimens can palliate cancer-related symptoms and modestly improve survival. We show how co... Full description

Journal Title: Journal of the National Cancer Institute August 16, 2000, Vol.92(16), pp.1321-1329
Main Author: Berthelot, J M
Other Authors: Will, B P , Evans, W K , Coyle, D , Earle, C C , Bordeleau, L
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 0027-8874
Link: http://search.proquest.com/docview/71784539/?pq-origsite=primo
Zum Text:
SendSend as email Add to Book BagAdd to Book Bag
Staff View
recordid: proquest71784539
title: Decision framework for chemotherapeutic interventions for metastatic non-small-cell lung cancer.
format: Article
creator:
  • Berthelot, J M
  • Will, B P
  • Evans, W K
  • Coyle, D
  • Earle, C C
  • Bordeleau, L
subjects:
  • Algorithms–Economics
  • Ambulatory Care–Therapeutic Use
  • Antineoplastic Combined Chemotherapy Protocols–Drug Therapy
  • Carcinoma, Non-Small-Cell Lung–Economics
  • Cost-Benefit Analysis–Secondary
  • Decision Trees–Drug Therapy
  • Humans–Economics
  • Lung Neoplasms–Pathology
  • Palliative Care–Economics
  • Quality of Life–Methods
  • Quality-Adjusted Life Years–Methods
  • Survival Analysis–Methods
  • Treatment Outcome–Methods
  • United States–Methods
  • Value of Life–Methods
ispartof: Journal of the National Cancer Institute, August 16, 2000, Vol.92(16), pp.1321-1329
description: BACKGROUNDBest supportive care has long been considered to be the standard therapy for metastatic non-small-cell lung cancer (NSCLC). There is now evidence from randomized trials that a number of chemotherapy regimens can palliate cancer-related symptoms and modestly improve survival. We show how cost-effectiveness analyses can be used to make choices between different (ambulatory) chemotherapy regimens. METHODSClinical algorithms describing the diagnosis, staging, and treatment of metastatic NSCLC were incorporated into Statistics Canada's Population Health Model. Using consistent methodology, we assessed the cost-effectiveness of several chemotherapeutic interventions: a combination of vindesine (VDS) plus cisplatin, etoposide (VP-16) plus cisplatin, vinblastine (VLB) plus cisplatin, vinorelbine (Navelbine; NVB) plus cisplatin, paclitaxel (Taxol) plus cisplatin, and gemcitabine (GEM) and NVB alone. We calculated the total chemotherapy costs in 1995 Canadian dollars, the cost per case, the average life-years saved, and the cost per life-year saved. Using the Population Health Model, we then constructed an advanced decision framework that rank-ordered the various treatment regimens so as to optimize benefit below various cost-effectiveness thresholds. RESULTSOne regimen (VLB plus cisplatin) appears to result in better survival and lower health care expenditures than best supportive care. By use of cost-effectiveness thresholds of $25,000 and $50,000 per life-year gained, NVB plus cisplatin is the preferred regimen. When quality of life is considered, however, GEM is preferred to NVB plus cisplatin at a threshold value of $50,000. At thresholds of $75 000 and $100,000, paclitaxel plus cisplatin at a dose of 135 mg/m(2) is the preferred regimen. At thresholds of $50,000 and above, best supportive care is the least preferred regimen. CONCLUSIONSThis decision framework allows the comparison of different treatment regimens based on various cost-effectiveness thresholds. Our analysis also supports the use of chemotherapy regimens and the abandonment of best supportive care as the standard of care for patients with advanced NSCLC. [J Natl Cancer Inst 2000;92:1321-9].
language: eng
source:
identifier: ISSN: 0027-8874
fulltext: fulltext
issn:
  • 00278874
  • 0027-8874
url: Link


@attributes
ID1117648330
RANK0.07
NO1
SEARCH_ENGINEprimo_central_multiple_fe
SEARCH_ENGINE_TYPEPrimo Central Search Engine
LOCALfalse
PrimoNMBib
record
control
sourcerecordid71784539
sourceidproquest
recordidTN_proquest71784539
sourcesystemPC
pqid71784539
galeid65229038
display
typearticle
titleDecision framework for chemotherapeutic interventions for metastatic non-small-cell lung cancer.
creatorBerthelot, J M ; Will, B P ; Evans, W K ; Coyle, D ; Earle, C C ; Bordeleau, L
contributorBerthelot, J M (correspondence author) ; Berthelot, J M (record owner)
ispartofJournal of the National Cancer Institute, August 16, 2000, Vol.92(16), pp.1321-1329
identifierISSN: 0027-8874
subjectAlgorithms–Economics ; Ambulatory Care–Therapeutic Use ; Antineoplastic Combined Chemotherapy Protocols–Drug Therapy ; Carcinoma, Non-Small-Cell Lung–Economics ; Cost-Benefit Analysis–Secondary ; Decision Trees–Drug Therapy ; Humans–Economics ; Lung Neoplasms–Pathology ; Palliative Care–Economics ; Quality of Life–Methods ; Quality-Adjusted Life Years–Methods ; Survival Analysis–Methods ; Treatment Outcome–Methods ; United States–Methods ; Value of Life–Methods
descriptionBACKGROUNDBest supportive care has long been considered to be the standard therapy for metastatic non-small-cell lung cancer (NSCLC). There is now evidence from randomized trials that a number of chemotherapy regimens can palliate cancer-related symptoms and modestly improve survival. We show how cost-effectiveness analyses can be used to make choices between different (ambulatory) chemotherapy regimens. METHODSClinical algorithms describing the diagnosis, staging, and treatment of metastatic NSCLC were incorporated into Statistics Canada's Population Health Model. Using consistent methodology, we assessed the cost-effectiveness of several chemotherapeutic interventions: a combination of vindesine (VDS) plus cisplatin, etoposide (VP-16) plus cisplatin, vinblastine (VLB) plus cisplatin, vinorelbine (Navelbine; NVB) plus cisplatin, paclitaxel (Taxol) plus cisplatin, and gemcitabine (GEM) and NVB alone. We calculated the total chemotherapy costs in 1995 Canadian dollars, the cost per case, the average life-years saved, and the cost per life-year saved. Using the Population Health Model, we then constructed an advanced decision framework that rank-ordered the various treatment regimens so as to optimize benefit below various cost-effectiveness thresholds. RESULTSOne regimen (VLB plus cisplatin) appears to result in better survival and lower health care expenditures than best supportive care. By use of cost-effectiveness thresholds of $25,000 and $50,000 per life-year gained, NVB plus cisplatin is the preferred regimen. When quality of life is considered, however, GEM is preferred to NVB plus cisplatin at a threshold value of $50,000. At thresholds of $75 000 and $100,000, paclitaxel plus cisplatin at a dose of 135 mg/m(2) is the preferred regimen. At thresholds of $50,000 and above, best supportive care is the least preferred regimen. CONCLUSIONSThis decision framework allows the comparison of different treatment regimens based on various cost-effectiveness thresholds. Our analysis also supports the use of chemotherapy regimens and the abandonment of best supportive care as the standard of care for patients with advanced NSCLC. [J Natl Cancer Inst 2000;92:1321-9].
languageeng
source
version7
lds50peer_reviewed
links
openurl$$Topenurl_article
openurlfulltext$$Topenurlfull_article
backlink$$Uhttp://search.proquest.com/docview/71784539/?pq-origsite=primo$$EView_record_in_ProQuest_(subscribers_only)
search
creatorcontrib
0Berthelot, J M
1Will, B P
2Evans, W K
3Coyle, D
4Earle, C C
5Bordeleau, L
titleDecision framework for chemotherapeutic interventions for metastatic non-small-cell lung cancer.
descriptionBACKGROUNDBest supportive care has long been considered to be the standard therapy for metastatic non-small-cell lung cancer (NSCLC). There is now evidence from randomized trials that a number of chemotherapy regimens can palliate cancer-related symptoms and modestly improve survival. We show how cost-effectiveness analyses can be used to make choices between different (ambulatory) chemotherapy regimens. METHODSClinical algorithms describing the diagnosis, staging, and treatment of metastatic NSCLC were incorporated into Statistics Canada's Population Health Model. Using consistent methodology, we assessed the cost-effectiveness of several chemotherapeutic interventions: a combination of vindesine (VDS) plus cisplatin, etoposide (VP-16) plus cisplatin, vinblastine (VLB) plus cisplatin, vinorelbine (Navelbine; NVB) plus cisplatin, paclitaxel (Taxol) plus cisplatin, and gemcitabine (GEM) and NVB alone. We calculated the total chemotherapy costs in 1995 Canadian dollars, the cost per case, the average life-years saved, and the cost per life-year saved. Using the Population Health Model, we then constructed an advanced decision framework that rank-ordered the various treatment regimens so as to optimize benefit below various cost-effectiveness thresholds. RESULTSOne regimen (VLB plus cisplatin) appears to result in better survival and lower health care expenditures than best supportive care. By use of cost-effectiveness thresholds of $25,000 and $50,000 per life-year gained, NVB plus cisplatin is the preferred regimen. When quality of life is considered, however, GEM is preferred to NVB plus cisplatin at a threshold value of $50,000. At thresholds of $75 000 and $100,000, paclitaxel plus cisplatin at a dose of 135 mg/m(2) is the preferred regimen. At thresholds of $50,000 and above, best supportive care is the least preferred regimen. CONCLUSIONSThis decision framework allows the comparison of different treatment regimens based on various cost-effectiveness thresholds. Our analysis also supports the use of chemotherapy regimens and the abandonment of best supportive care as the standard of care for patients with advanced NSCLC. [J Natl Cancer Inst 2000;92:1321-9].
subject
0Algorithms–Economics
1Ambulatory Care–Therapeutic Use
2Antineoplastic Combined Chemotherapy Protocols–Drug Therapy
3Carcinoma, Non-Small-Cell Lung–Economics
4Cost-Benefit Analysis–Secondary
5Decision Trees–Drug Therapy
6Humans–Economics
7Lung Neoplasms–Pathology
8Palliative Care–Economics
9Quality of Life–Methods
10Quality-Adjusted Life Years–Methods
11Survival Analysis–Methods
12Treatment Outcome–Methods
13United States–Methods
14Value of Life–Methods
general
0English
1MEDLINE (ProQuest)
2ProQuest Biological Science Collection
3ProQuest Natural Science Collection
4ProQuest SciTech Collection
5Biological Science Database
6Natural Science Collection
7SciTech Premium Collection
8Health Research Premium Collection
9Health Research Premium Collection (Alumni edition)
10Biological Science Index (ProQuest)
sourceidproquest
recordidproquest71784539
issn
000278874
10027-8874
rsrctypearticle
creationdate2000
addtitleJournal of the National Cancer Institute
searchscope
01007527
11007944
21009130
310000004
410000038
510000050
610000120
710000159
810000238
910000253
1010000260
1110000270
1210000271
1310000302
1410000350
15proquest
scope
01007527
11007944
21009130
310000004
410000038
510000050
610000120
710000159
810000238
910000253
1010000260
1110000270
1210000271
1310000302
1410000350
15proquest
lsr43
01007527false
11007944false
21009130false
310000004false
410000038false
510000050false
610000120false
710000159false
810000238false
910000253false
1010000260false
1110000270false
1210000271false
1310000302false
1410000350false
contributorBerthelot, J M
startdate20000816
enddate20000816
citationpf 1321 pt 1329 vol 92 issue 16
lsr30VSR-Enriched:[doi, pqid, eissn, galeid]
sort
titleDecision framework for chemotherapeutic interventions for metastatic non-small-cell lung cancer.
authorBerthelot, J M ; Will, B P ; Evans, W K ; Coyle, D ; Earle, C C ; Bordeleau, L
creationdate20000816
lso0120000816
facets
frbrgroupid8067026129778631860
frbrtype5
newrecords20181218
languageeng
creationdate2000
topic
0Algorithms–Economics
1Ambulatory Care–Therapeutic Use
2Antineoplastic Combined Chemotherapy Protocols–Drug Therapy
3Carcinoma, Non-Small-Cell Lung–Economics
4Cost-Benefit Analysis–Secondary
5Decision Trees–Drug Therapy
6Humans–Economics
7Lung Neoplasms–Pathology
8Palliative Care–Economics
9Quality of Life–Methods
10Quality-Adjusted Life Years–Methods
11Survival Analysis–Methods
12Treatment Outcome–Methods
13United States–Methods
14Value of Life–Methods
collection
0MEDLINE (ProQuest)
1ProQuest Biological Science Collection
2ProQuest Natural Science Collection
3ProQuest SciTech Collection
4Biological Science Database
5Natural Science Collection
6SciTech Premium Collection
7Health Research Premium Collection
8Health Research Premium Collection (Alumni edition)
9Biological Science Index (ProQuest)
prefilterarticles
rsrctypearticles
creatorcontrib
0Berthelot, J M
1Will, B P
2Evans, W K
3Coyle, D
4Earle, C C
5Bordeleau, L
jtitleJournal of the National Cancer Institute
toplevelpeer_reviewed
delivery
delcategoryRemote Search Resource
fulltextfulltext
addata
aulast
0Berthelot
1Will
2Evans
3Coyle
4Earle
5Bordeleau
aufirst
0J M
1B P
2W K
3D
4C C
5L
au
0Berthelot, J M
1Will, B P
2Evans, W K
3Coyle, D
4Earle, C C
5Bordeleau, L
addauBerthelot, J M
atitleDecision framework for chemotherapeutic interventions for metastatic non-small-cell lung cancer.
jtitleJournal of the National Cancer Institute
risdate20000816
volume92
issue16
spage1321
epage1329
pages1321-1329
issn0027-8874
formatjournal
genrearticle
ristypeJOUR
abstractBACKGROUNDBest supportive care has long been considered to be the standard therapy for metastatic non-small-cell lung cancer (NSCLC). There is now evidence from randomized trials that a number of chemotherapy regimens can palliate cancer-related symptoms and modestly improve survival. We show how cost-effectiveness analyses can be used to make choices between different (ambulatory) chemotherapy regimens. METHODSClinical algorithms describing the diagnosis, staging, and treatment of metastatic NSCLC were incorporated into Statistics Canada's Population Health Model. Using consistent methodology, we assessed the cost-effectiveness of several chemotherapeutic interventions: a combination of vindesine (VDS) plus cisplatin, etoposide (VP-16) plus cisplatin, vinblastine (VLB) plus cisplatin, vinorelbine (Navelbine; NVB) plus cisplatin, paclitaxel (Taxol) plus cisplatin, and gemcitabine (GEM) and NVB alone. We calculated the total chemotherapy costs in 1995 Canadian dollars, the cost per case, the average life-years saved, and the cost per life-year saved. Using the Population Health Model, we then constructed an advanced decision framework that rank-ordered the various treatment regimens so as to optimize benefit below various cost-effectiveness thresholds. RESULTSOne regimen (VLB plus cisplatin) appears to result in better survival and lower health care expenditures than best supportive care. By use of cost-effectiveness thresholds of $25,000 and $50,000 per life-year gained, NVB plus cisplatin is the preferred regimen. When quality of life is considered, however, GEM is preferred to NVB plus cisplatin at a threshold value of $50,000. At thresholds of $75 000 and $100,000, paclitaxel plus cisplatin at a dose of 135 mg/m(2) is the preferred regimen. At thresholds of $50,000 and above, best supportive care is the least preferred regimen. CONCLUSIONSThis decision framework allows the comparison of different treatment regimens based on various cost-effectiveness thresholds. Our analysis also supports the use of chemotherapy regimens and the abandonment of best supportive care as the standard of care for patients with advanced NSCLC. [J Natl Cancer Inst 2000;92:1321-9].
urlhttp://search.proquest.com/docview/71784539/
doi10.1093/jnci/92.16.1321
eissn14602105
date2000-08-16