Optimizing the use of adjuvant chemotherapy in non-small cell lung cancer patients with comorbidities
| Autor: | Stacyann Bailey, Qian Wang, Chung Yin Kong, Kimberly Stone, Rajwanth Veluswamy, Susan E. Bates, Cardinale B. Smith, Juan P. Wisnivesky, Keith Sigel |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Cancer Research
Lung Neoplasms Adenocarcinoma Article Pulmonary Disease Chronic Obstructive Oncology Chemotherapy Adjuvant Carcinoma Non-Small-Cell Lung Antineoplastic Combined Chemotherapy Protocols Carcinoma Squamous Cell Humans Renal Insufficiency Chronic Neoplasm Staging Randomized Controlled Trials as Topic |
| Zdroj: | Curr Probl Cancer |
| Popis: | Veterans with locoregional non-small cell lung cancer (NSCLC) may benefit from adjuvant chemotherapy. However, comorbidities and other factors may impact the harms and benefits of this treatment. Here, we identified the optimal indications for adjuvant chemotherapy in Veterans with NSCLC, chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), and/or coronary artery disease (CAD). We used data from randomized controlled trials (RCTs) and Veterans Administration (VA) databases to enhance a simulation model. Then, we conducted in-silico RCTs comparing adjuvant chemotherapy vs observation among Veterans with stage II-IIIA NSCLC. Among Veterans without COPD or CKD, adjuvant chemotherapy was the optimal strategy regardless of the presence or absence of CAD except for patients > 70 years with squamous cell carcinoma. Conversely, most veterans without COPD but with CKD were optimally managed with observation. Veterans with COPD but without CKD, benefited from adjuvant chemotherapy if they were ≤70 years with stage II-IIIA adenocarcinoma or |
| Databáze: | OpenAIRE |
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