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- W2247455113 abstract "3627 Background: Advances in the treatment of metastatic colorectal cancer (mCRC) have improved median overall survival (mOS) from 1yr with 5-fluorouracil (FU) therapy to >21 mos. This may come at cost of more toxicity. As the number of tested regimens increases, the question arises how to best present palliative treatment options. We present a simple way to compare treatment options in terms of risks & benefits. Methods: The literature was surveyed for reports of 1 st -line systemic therapies for mCRC. The largest recent reports with detailed toxicity data were selected as representative for a regimen; if several comparable reports existed then all were selected. Toxicity sum (TS) of a regimen was calculated as % occurences in the study cohort of severe (≥ gr. 3) adverse effects: diarrhea+mucositis+neurocutaneous (excl. alopecia)+vomiting (or vomiting/nausea if not reported separately or nausea if no vomiting rep.)+febrile neutropenia (FN)(or infection if FN not rep. or leukopenia if infection not rep.)+toxic deathrate. Benefits (OS & progression-free survival PFS in months) were divided by TS to give a benefit/toxicity (B/T) ratio & plotted as benefit vs TS. Results: 30 regimens were found.OS, PFS & TS for the various regimens ranged from 8.9–24.7 and 4.9–9.2 mos, & 12–63 respectively. B/T ratios ranged from 0.1–0.53 (PFS) & 0.22–1.19 (OS); higher values more favorable. Regimens with similar B/T ratios may still differ - longer OS & PFS but at cost of more toxicity. Graphical presentation makes this clear. Intriguing & open to interpretation was a narrow range of PFS while OS varied greatly between regimens. Weaknesses of our study incl omission of some regimen-specific toxicities, & of symptom control benefit. Conclusions: Our comparative tool helps physicians discuss the large number of available options & their clinical differences easily with patients, improving informed consent & disclosure, in order to arrive at the treatment plan most appropriate to the individual. [Table: see text] [Table: see text]" @default.
- W2247455113 created "2016-06-24" @default.
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- W2247455113 date "2006-06-20" @default.
- W2247455113 modified "2023-09-25" @default.
- W2247455113 title "Mathematization of risk and benefit for first-line treatment of metastatic colorectal cancer: A graphical decision aid for patients and physicians" @default.
- W2247455113 doi "https://doi.org/10.1200/jco.2006.24.18_suppl.3627" @default.
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