Treatment of Advanced Colorectal Cancer (CRC) in Daily Practice: Results of a Survey in two Italian Regions, Piemonte and Valle D'aosta
| Autor: | Dal Canton O, C. Oliva, Alessandro Comandone, Cesare Bumma, Di Napoli A, Faggiuolo R, P. Bergnolo, Antonella Boglione, Berardo R |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Colorectal cancer Disease 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine Aged Response rate (survey) Performance status business.industry General surgery Gold standard Cancer General Medicine Middle Aged medicine.disease Surgery Irinotecan Italy Oncology Chemotherapy Adjuvant Health Care Surveys 030220 oncology & carcinogenesis Female Colorectal Neoplasms business Raltitrexed medicine.drug |
| Zdroj: | Tumori Journal. 84:562-566 |
| ISSN: | 2038-2529 0300-8916 |
| Popis: | Aims and background Colorectal cancer (CRC) is one of the most important health problems in Western countries: it is the fourth cancer in terms of incidence and the second cause of cancer death. Surgery is the main therapeutic choice and there is broad consensus on the role of adjuvant chemotherapy (CT) after resection. Unfortunately, 50% of the patients will relapse and die of the disease. Palliative CT based on 5-fluorouracil (5FU) may induce a 9-48% response rate with a median survival of 11.5 months. At present there is no gold standard for CT in advanced CRC and the situation has become more complicated since the advent of new drugs (Raltitrexed, Irinotecan, Oxaliplatin). The aim of this study was the identification of the different approaches to treatment of advanced CRC among the clinicians (oncologists, radiologists, internal medicine specialists, surgeons) who practice CT. Methods and study design Forty-six clinicians from two Italian Regions (Piemonte and Valle d'Aosta) were interviewed by telephone. Results 5FU modulated with Lederfolin according to the classic Machover scheme is the main option in daily practice. More sophisticated therapies are reserved to patients with a good performance status (PS) and are prescribed only in the larger centers. The planned therapies usually consist of six courses. Restaging may be performed after three or six courses. A marked difference has been recorded in the evaluation of a situation of no change (NC): 25.5% of the clinicians evaluate stable disease as a positive result. In the event of disease progression or relapse, 35% of the clinicians do not prescribe second-line CT. In case of further treatment, the options are totally subjective. Conclusions A national survey on this issue is necessary under the auspices of AIOM (Associazione Italiana Oncologia Medica) and involving oncologists, epidemiologists and statisticians, in order to define the reasons for variations in therapy in advanced CRC and determine the differences between clinicians of different age, specialization and location. This survey could lead to a definition of guidelines for the treatment of advanced CRC. |
| Databáze: | OpenAIRE |
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