Linked Life Data

11438417

Source:http://linkedlifedata.com/resource/pubmed/id/11438417

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
7
pubmed:dateCreated
2001-7-4
pubmed:abstractText
To assess comparatively, in terms of quality-adjusted survival, three front-line treatments in patients with stage B- or C-chronic lymphocytic leukemia (CLL). To describe better and compare the survival after randomization of patients from the CLL90 trial that randomly compared ChOP (cyclophosphamide, doxorubicin, oncovin, prednisone), CAP (cyclophosphamide, doxorubicin, prednisone) and fludarabine in advanced CLL, we performed a quality-adjusted survival analysis. This consisted of defining four clinical states (toxicity, treatment free of toxicity, no treatment nor symptoms, relapse), then summing up the average times spent in each state weighted by utility coefficients that reflect relative value according to quality of life. The resulting quality-adjusted time without symptoms or toxicity (Q-TWIST) was compared between randomized groups, and sensitivity (threshold) analyses to the choice of utility coefficients was performed. Over 73 months after randomization, the fludarabine group gained a mean of 45 days of toxicity-free survival at CAP, and 61 days over ChOP. The mean TWIST was 27.05 months with CAP, 31.5 months with ChOP and 32.95 months with fludarabine. The threshold analyses showed that, whatever the utility weights, the mean Q-TWIST was always greater with ChOP or fludarabine as compared to CAP. Fludarabine was consistently a better treatment than ChOP, except in the unlikely case of high utility weights attributed to toxicity and low utility weights attributed to treatment. Nevertheless, from a clinical point of view, differences between ChOP and fludarabine were moderate or event slight (mean difference in TWIST of 1.45 months). We conclude that patients with advanced CLL have a moderate benefit in terms of Q-TWIST when treated with fludarabine over ChOP. These two treatments are always superior to CAP.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jul
pubmed:issn
0895-4356
pubmed:author
pubmed:issnType
Print
pubmed:volume
54
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
747-54
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed-meshheading:11438417-Aged, pubmed-meshheading:11438417-Antineoplastic Agents, pubmed-meshheading:11438417-Antineoplastic Combined Chemotherapy Protocols, pubmed-meshheading:11438417-Cyclophosphamide, pubmed-meshheading:11438417-Doxorubicin, pubmed-meshheading:11438417-Female, pubmed-meshheading:11438417-Humans, pubmed-meshheading:11438417-Leukemia, Lymphocytic, Chronic, B-Cell, pubmed-meshheading:11438417-Male, pubmed-meshheading:11438417-Middle Aged, pubmed-meshheading:11438417-Prednisone, pubmed-meshheading:11438417-Quality of Life, pubmed-meshheading:11438417-Randomized Controlled Trials as Topic, pubmed-meshheading:11438417-Sensitivity and Specificity, pubmed-meshheading:11438417-Survival Analysis, pubmed-meshheading:11438417-Treatment Outcome, pubmed-meshheading:11438417-Vidarabine, pubmed-meshheading:11438417-Vincristine
pubmed:year
2001
pubmed:articleTitle
Evaluating treatment strategies in chronic lymphocytic leukemia: use of quality-adjusted survival analysis.
pubmed:affiliation
Département de Biostatistique et Informatique Médicale, Hôpital Saint Louis, 1 Avenue Claude Vellefaux, 75475 Paris, France.
pubmed:publicationType
Journal Article, Clinical Trial, Comparative Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't