Cancer
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Randomized Controlled Trial Multicenter Study Comparative Study
Updated efficacy and toxicity analysis of irinotecan and oxaliplatin (IROX) : intergroup trial N9741 in first-line treatment of metastatic colorectal cancer.
Efficacy and toxicity of oxaliplatin (Eloxatin; Sanofi-Aventis, Paris, France) combined with irinotecan (IROX) were examined in 383 patients enrolled on the IROX arm of Intergroup Study N9741. ⋯ IROX was found to be less active than FOLFOX but with a similar toxicity profile except in patients ages >70 years. Although IROX may be considered in patients intolerant of 5-FU or in patients known to have a dihydropyrimidine dehydrogenase (DPD) deficiency, it should be used with caution in older patients.
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Adding trastuzumab to adjuvant chemotherapy provides significant clinical benefit in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. A cost-effectiveness analysis was performed to assess clinical and economic implications of adding trastuzumab to adjuvant chemotherapy, based upon joint analysis of NSABP B-31 and NCCTG N9831 trials. ⋯ Trastuzumab for adjuvant treatment of early stage breast cancer was projected to be cost effective over a lifetime horizon, achieving a cost-effectiveness ratio below that of many widely accepted oncology treatments.
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Information regarding patient outcomes, complications, and mortality after surgery for spinal metastasis has previously been derived from single-institution series. The aim of this study was to report inpatient mortality, complications, and outcomes on a national level. ⋯ A national perspective is provided on inpatient complications and outcomes after surgery for spinal metastasis in the U.S. The significant negative effect of postoperative complications on mortality and resource utilization is demonstrated. Furthermore, preoperative comorbidity is identified as an important risk factor and its impact is defined on patient outcomes.