[Clinical and economic evaluation of the initial assessment of small cell cancer of the lung. Alternatives to classic evaluation. LGTO. The Lyon Group of Thoracic Oncology]
Journal - Revue des maladies respiratoires (FRANCE )
Alternatively to the usual evaluation summary, a characteristic of small cell lung cancer, is the probability of significant diffuse metastases; the prognosis is directly linked to the extent of these metastases. Moreover, the assessment of the initial extension becomes heavier and more costly as investigations continue and each new technology appears. In order to evaluate the contribution of each examination, a classification has been established as a function of the time-scale to obtain the results, of the technology involved, or whether the investigation is painful or not and any likelihood of iatrogenic side-effects. An assessment in three stages is proposed to achieve the most effective and cheapest diagnosis possible. In relation to the usual technique of assessment this sequential approach allows for a 27% reduction in the time-scale for the diagnosis of diffuse disease, 51.3% in terms of technical involvement, 46.3% in terms of pain and discomfort and 53.9% in terms of iatrogenic potential. At the same time a reduction in cost of 47.5% is observed.
|ISSN : ||0761-8425|
|Mesh Heading : ||Alkaline Phosphatase Attitude to Health Biopsy Bone Neoplasms Brain Neoplasms Carcinoma, Small Cell Decision Making Diagnostic Imaging Evaluation Studies as Topic Humans L-Lactate Dehydrogenase Liver Neoplasms Lung Neoplasms Lymph Nodes Neoplasm Staging Reproducibility of Results Retrospective Studies Tumor Markers, Biological analysis radionuclide imaging secondary radionuclide imaging secondary economics psychology economics methods analysis secondary ultrasonography economics psychology pathology economics methods analysis|
|Mesh Heading Relevant : ||diagnosis secondary diagnosis|
[Prognostic factors in the response of a first line chemotherapy in advanced breast cancer]
Journal - Bulletin du cancer (FRANCE )
Anthracyclines containing regimen are widely used in advanced breast cancer. The response to first line chemotherapy varies according to many individual factors and the theoretical response to a given protocol cannot predict the response of a patient. A randomized clinical trial (ERASME) was initiated in order to evaluate the more appropriate first line chemotherapy scheme in advanced breast cancer. Prognostic factors were included in a multiple logistic regression to explain the response after the first 3 chemotherapy courses (monthly FEC). Three factors were found to be statistically significant: adjuvant hormonotherapy, loco-regional metastases, adjuvant adriamycin containing regimen (pejorative prognostic factor). By combining these factors, this statistical model enables us to predict a response rate to a first line chemotherapy from 27 to 87%. Such a model can be taken into account in a decision-making procedure of first line chemotherapy in advanced breast cancer.
|ISSN : ||0007-4551|
|Mesh Heading : ||Aged Antineoplastic Combined Chemotherapy Protocols Breast Neoplasms Female Humans Middle Aged Neoplasm Metastasis Neoplasm Recurrence, Local Prognosis Regression Analysis|
|Mesh Heading Relevant : ||therapeutic use drug therapy|