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  • 1995-1999  (7)
  • 1
    Online Resource
    Online Resource
    High-dose chemotherapy with autologous hematopoietic stem-cell support for breast cancer in North America.
    American Society of Clinical Oncology (ASCO) ; 1997
    In:  Journal of Clinical Oncology Vol. 15, No. 5 ( 1997-05), p. 1870-1879
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 15, No. 5 ( 1997-05), p. 1870-1879
    Abstract: To identify trends in high-dose therapy with autologous hematopoietic stem-cell support (autotransplants) for breast cancer (1989 to 1995). PATIENTS AND METHODS Analysis of patients who received autotransplants and were reported to the Autologous Blood and Marrow Transplant Registry. Between January 1, 1989 and June 30, 1995, 19,291 autotransplants were reviewed; 5,886 were for breast cancer. Main outcomes were progression-free survival (PFS) and survival. RESULTS Between 1989 and 1995, autotransplants for breast cancer increased sixfold. After 1992, breast cancer was the most common indication for autotransplant. Significant trends included increasing use for locally advanced rather than metastatic disease (P 〈 .00001) and use of blood-derived rather than marrow-derived stem cells (P 〈 .00001). One-hundred-day mortality decreased from 22% to 5% (P 〈 .0001). Three-year PFS probabilities were 65% (95% confidence intervals [Cls], 59 to 71) for stage 2 disease, and 60% (95% Cl, 53 to 67) for stage 3 disease. In metastatic breast cancer, 3-year probabilities of PFS were 7% (95% Cl, 4 to 10) for women with no response to conventional dose chemotherapy; 13% (95% Cl, 9 to 17) for those with partial response; and 32% (95% Cl, 27 to 37) for those with complete response. Eleven percent of women with stage 2/3 disease and less than 1% of those with stage 4 disease participated in national cooperative group randomized trials. CONCLUSION Autotransplants increasingly are used to treat breast cancer. One-hundred-day mortality has decreased substantially. Three-year survival is better in women with earlier stage disease and in those who respond to pretransplant chemotherapy.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.1997.15.5.1870
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 1997
    detail.hit.zdb_id: 2005181-5
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  • 2
    Online Resource
    Online Resource
    Novel scanning near-field optical microscope (SNOM)/scanning confocal optical microscope based on normal force distance regulation and bent etched fiber tips
    AIP Publishing ; 1999
    In:  Review of Scientific Instruments Vol. 70, No. 6 ( 1999-06-01), p. 2751-2757
    Details
    In: Review of Scientific Instruments, AIP Publishing, Vol. 70, No. 6 ( 1999-06-01), p. 2751-2757
    Abstract: We report on a unique combination of a novel scanning near-field optical microscope/scanning confocal optical microscope based on normal force distance regulation with bent etched fiber tips. The use of normal force detection makes all classic atomic force microscope operation modes such as contact mode and tapping mode accessible to scanning near-field optical microscopy (SNOM), thus allowing near-field optical imaging at sample distances unavailable to shear force regulated distance control. The SNOM laser light is pulsed or detected synchronously to the fiber tapping amplitude to illuminate the sample at a predetermined height above the sample. Bent etched fiber tips are used, whose fiber diameters are additionally etched down to yield resonant frequencies between 60 and 300 kHz, Q factors around 180 and spring constants in the range of 80–400 N/m. The typical roughness of the tip cone surfaces is shown to be due to etching in a meniscus. For the first time, simultaneously acquired constant gap width mode topography and constant height mode near-field optical images are presented, allowing topography induced contrast to be separated from true optical contrast such as absorption and fluorescence.
    Type of Medium: Online Resource
    ISSN: 0034-6748 , 1089-7623
    URL: Article
    DOI: 10.1063/1.1149840
    Language: English
    Publisher: AIP Publishing
    Publication Date: 1999
    detail.hit.zdb_id: 209865-9
    detail.hit.zdb_id: 1472905-2
    SSG: 11
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Methodological and statistical issues of quality of life (QoL) and economic evaluation in cancer clinical trials: report of a workshop
    Elsevier BV ; 1998
    In:  European Journal of Cancer Vol. 34, No. 9 ( 1998-08), p. 1317-1333
    Details
    In: European Journal of Cancer, Elsevier BV, Vol. 34, No. 9 ( 1998-08), p. 1317-1333
    Type of Medium: Online Resource
    ISSN: 0959-8049
    URL: Article
    DOI: 10.1016/S0959-8049(98)00074-4
    RVK:
    XA 42017.A
    RVK:
    XA 42017
    Language: English
    Publisher: Elsevier BV
    Publication Date: 1998
    detail.hit.zdb_id: 1120460-6
    detail.hit.zdb_id: 1468190-0
    detail.hit.zdb_id: 82061-1
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  • 4
    Online Resource
    Online Resource
    Measuring standards of care for early breast cancer in an insured population.
    American Society of Clinical Oncology (ASCO) ; 1997
    In:  Journal of Clinical Oncology Vol. 15, No. 4 ( 1997-04), p. 1401-1408
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 15, No. 4 ( 1997-04), p. 1401-1408
    Abstract: To demonstrate the use of a combined data base to evaluate the care for local/regional invasive breast cancer in a large insured population of women aged less than 64 years. PATIENTS AND METHODS We linked the procedural and hospital claims from Blue Cross Blue Shield (BCBS) of Virginia with clinical stage data from the Virginia Cancer Registry (VCR) from 1989 to 1991. A total of 918 women were assessed with a median age of 50 years; 68% had tumors less than 2 cm, 30% had positive axillary nodes, and 68% were assessed as having local summary stage. A quality-of-care "report card" was used based on standards of care from international Consensus Conferences. RESULTS Eight percent had a mastectomy as the initial biopsy procedure. Sixty-nine percent of women ultimately underwent mastectomy. Of those women who underwent lumpectomy, 86% had subsequent radiation. Within 3 months of diagnosis, 43% had a bone scan and 20% a computed tomography (CT) scan. Of women with positive axillary lymph nodes, 83% aged less than 51 years and 52% aged 51 to 64 years received chemotherapy. Fifty-six percent of all women had claims from a medical oncologist. Of women having a total mastectomy, 27% had claims from a plastic surgeon. Sixty-six percent to 76% of women had a mammogram, 24% a bone scan, and 14% a CT scan in the 0-18 and 18-36 month intervals following primary treatment. CONCLUSION This study confirms the feasibility of linking sources of data that provide complementary information needed to develop measurements regarding standards of quality and efficiency of oncologic care. This report should serve as an initial benchmark while we await reports from other populations to define the best practice.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.1997.15.4.1401
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 1997
    detail.hit.zdb_id: 2005181-5
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  • 5
    Online Resource
    Online Resource
    Economic evaluation of a randomized clinical trial comparing vinorelbine, vinorelbine plus cisplatin, and vindesine plus cisplatin for non-small-cell lung cancer.
    American Society of Clinical Oncology (ASCO) ; 1995
    In:  Journal of Clinical Oncology Vol. 13, No. 9 ( 1995-09), p. 2166-2173
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 13, No. 9 ( 1995-09), p. 2166-2173
    Abstract: To estimate the comparative cost-effectiveness of three regimens for metastatic non-small-cell lung cancer (NSCLC). METHODS Results from a randomized clinical trial of 612 European patients with NSCLC, and cost data from an academic cancer center, the Medical College of Virginia, were analyzed. In this post-hoc economic analysis, we compared vinorelbine alone, vinorelbine plus cisplatin, and a common regimen of vindesine plus cisplatin. RESULTS Vinorelbine plus cisplatin resulted in the longest mean survival time of the three regimens, 49.6 weeks, followed by vindesine plus cisplatin, 44.3 weeks, and vinorelbine, 41.6 weeks. Compared with vinorelbine alone, vinorelbine plus cisplatin added 56 days at a cost of $2,700, resulting in a cost-effectiveness ratio of $17,700 per year of life gained. Similarly, vindesine plus cisplatin added 19 days at a cost of $1,150, or $22,100 per year of life gained. Compared with vindesine plus cisplatin, vinorelbine plus cisplatin added 37 days at a cost of $1,570, or $15,500 per year of life gained. CONCLUSION The most effective regimen of vinorelbine plus cisplatin added substantial benefit compared with vinorelbine alone or another common treatment, vindesine plus cisplatin, at a cost-effectiveness within accepted limits for medical interventions. Vindesine plus cisplatin also added benefit at an acceptable cost per year of life gained. If vinorelbine is preferred because of its toxicity profile, the additional effectiveness of cisplatin added substantial benefit at an acceptable cost. Compared with other common medical interventions, chemotherapy for NSCLC has acceptable efficacy and cost-effectiveness and should not be arbitrarily denied based on clinical or economic grounds.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.1995.13.9.2166
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 1995
    detail.hit.zdb_id: 2005181-5
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  • 6
    Online Resource
    Online Resource
    Costs of care associated with non-small-cell lung cancer in a commercially insured cohort.
    American Society of Clinical Oncology (ASCO) ; 1998
    In:  Journal of Clinical Oncology Vol. 16, No. 4 ( 1998-04), p. 1420-1424
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 16, No. 4 ( 1998-04), p. 1420-1424
    Abstract: To examine the cost of incident cases of non-small-cell lung cancer (NSCLC) in a commercially insured cohort. METHODS Claims from Virginia Blue Cross and Blue Shield (BCBS) beneficiaries with lung cancer from 1989 to 1991 were merged with records from the Virginia Cancer Registry (VCR). Data from the VCR identified incident cases, stage, and type of cancer at diagnosis. Costs for all medical care included insurance payment, copayments, and deductibles for 2 years after diagnosis or until death. RESULTS Three hundred forty-nine incident NSCLC patients were evaluated. The mean 2-year cost for each patient after diagnosis or until death was $47,941 (95% confidence interval, $43,758 to $52,124). Total average costs and hospital days were significantly lower for local disease ($37,514, 21.2 days), but were similar for regional ($52,797, 30.0 days) and distant ($49,382, 33.0 days) disease. Hospital days accounted for 48% and hospital-based claims for 70% of costs. Initial treatments, which included radiation, unadjusted for stage, had the lowest survival rates and the highest costs, and were associated with the most hospital days. Initial stage, race, gender, and age were not predictors of total 2-year costs. The independent predictors of total 2-year costs were type of treatment: any radiation therapy, any surgery, or any chemotherapy (all, P 〈 .001). Inpatient hospital days was only a modest predictor of costs after adjusting for type of treatment. Patients who survived less than 1 year spent 30.5 days in hospital and had an average cost of $47,280. CONCLUSION The direct health care costs of younger NSCLC patients care are substantial. These results should serve as a benchmark for future comparisons as the United States market shifts to managed care.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.1998.16.4.1420
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 1998
    detail.hit.zdb_id: 2005181-5
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  • 7
    Online Resource
    Online Resource
    Economic analysis of a randomized clinical trial to compare filgrastim-mobilized peripheral-blood progenitor-cell transplantation and autologous bone marrow transplantation in patients with Hodgkin's and non-Hodgkin's lymphoma.
    American Society of Clinical Oncology (ASCO) ; 1997
    In:  Journal of Clinical Oncology Vol. 15, No. 1 ( 1997-01), p. 5-10
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 15, No. 1 ( 1997-01), p. 5-10
    Abstract: High-dose chemotherapy (HDC) with peripheral-blood progenitor cell (PBPC) and autologous bone marrow (ABM) transplant (T) has documented survival benefits for relapsed Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL). Treatment costs associated with HDC and its supportive care have restricted its use both on and off clinical trial. In a prospective randomized clinical trial, filgrastim-mobilized PBPCT resulted in faster recovery of bone marrow function, with less hospitalization and supportive care than ABMT. This study was undertaken to analyze the costs of the two strategies using prospectively collected data from a randomized clinical trial that compared filgrastim-mobilized PBPCT versus ABMT. PATIENTS AND METHODS Clinical results and resource utilization from a randomized clinical trial that compared filgrastim-mobilized PBPCT versus ABMT following carmustine, etoposide, cytarabine, and melphalan (BEAM) HDC for HD and NHL are presented. The trial was performed in six centers in Germany, the United Kingdom, and Belgium. Resource utilization data were used to project costs and Massay Cancer Center (MCC) in the United States incurred the cost of treating the cohort. Costs were projected to the United States, because the economic implications to United States centers are significant, costs of care vary markedly among countries but resource utilization on this trial did not, and a randomized trial is unlikely to be performed in the United States. RESULTS Fifty-eight patients with relapsed HD or NHL underwent HDC with BEAM. The PBPCT and ABMT groups had similar short-term survival after BEAM. PBPCT patients had a shorter hospitalization (median, 17 v 23 days; P = .002), neutrophil recovery (11 v 14 days; P = .005), platelet recovery to 〉 or = 20 x 10(9)/L (16 v 23 days; P = .02), and days of platelet transfusions (6 v 10; P 〈 .001). Estimated costs were $8,531 for ABM harvest and $5,760 for PBPC collection, including filgrastim mobilization. The total estimated average cost was $59,314 for each ABMT patient versus $45,792 for each PBPCT patient. Cost savings of $13,521 (23%) were due to shorter hospitalizations with less supportive care. CONCLUSION PBPCT is as safe and more effective than ABMT for HD and NHL in the short term. PBPCT represents a significant cost savings due to lower autograft collection costs, shorter hospital stays, and less supportive care. The savings exceed the costs for filgrastim mobilization and PBPC collection. Actual savings will vary depending on local practice patterns, charges, and costs.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.1997.15.1.5
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 1997
    detail.hit.zdb_id: 2005181-5
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