1. Epidemiology and treatment costs of bone metastases from lung cancer: a French prospective, observational, multicenter study (GFPC 0601)
- Author
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Chantal, Decroisette, Isabelle, Monnet, Henri, Berard, Gilles, Quere, Herve, Le Caer, Suzanna, Bota, Clarisse, Audigier-Valette, Laurence, Geriniere, Jean-Marc, Vernejoux, Christos, Chouaid, C, Daniel, Centre de recherche sur les Ions, les MAtériaux et la Photonique (CIMAP - UMR 6252), Centre National de la Recherche Scientifique (CNRS)-École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Caen Normandie (UNICAEN), Normandie Université (NU), Centre d'études sur les réseaux, les transports, l'urbanisme et les constructions publiques (CERTU), Avant création Cerema, Service de pneumologie, oncologie thoracique et soins intensifs respiratoires [Rouen], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Hôpital Charles Nicolle [Rouen]-CHU Rouen, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), C Decroisette, Monnet-je, Groupe Français de Pneumo-Cancérologie 0601 de l'équipe ., H Berard, G Quere, H Caer Le, S Bota, C-Valette Audigier, L Geriniere, JM Vernejoux, Chouaid C, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche sur les Matériaux Avancés (IRMA), Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Rouen Normandie (UNIROUEN), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN)
- Subjects
Male ,Lung Neoplasms ,medicine.medical_treatment ,Cost-Benefit Analysis ,Indirect costs ,0302 clinical medicine ,Non-small cell lung cancer ,Carcinoma, Non-Small-Cell Lung ,Epidemiology ,Antineoplastic Combined Chemotherapy Protocols ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Aged, 80 and over ,Biphosphonates ,Diphosphonates ,Radiotherapy Dosage ,Health Care Costs ,Middle Aged ,Combined Modality Therapy ,Markov Chains ,3. Good health ,Survival Rate ,Treatment Outcome ,Oncology ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Female ,France ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Bone Neoplasms ,Adenocarcinoma ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Lung cancer ,Survival rate ,Zoledronic acid ,Aged ,Neoplasm Staging ,Retrospective Studies ,Performance status ,business.industry ,Bone metastases ,Retrospective cohort study ,medicine.disease ,Small Cell Lung Carcinoma ,Surgery ,Costs ,Radiation therapy ,Carcinoma, Large Cell ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Follow-Up Studies - Abstract
International audience; INTRODUCTION: The aim of this prospective, observational, multicenter study was to examine the epidemiology and management costs of bone metastatic disease (BMD) in patients with lung cancer. METHODS: The analysis included all patients with BMD from lung cancer diagnosed between May 2006 and May 2007 in 40 centers. We analyzed their management and the direct costs of BMD from the health care provider's perspective, using a Markov model. Skeletal-related event (SRE) was defined as pathological fractures, spinal cord compression, or hypercalcemia (clinical SRE [cSRE]) for an initial analysis; a second analysis included palliative radiotherapy and surgery (therapeutic SRE [tSRE]). RESULTS: Among the 554 patients enrolled (62 ± 11 years, 76.5% males, 69.3% performance status 0/1, 91% non-small cell lung cancer), 24.7% had a cSRE and 26.7% a tSRE at baseline and 9% and 39% during follow-up, respectively; 81.8% received at least one chemotherapy cycle. The median survival time was 5.8 months, and the 1- and 2-year survival rates were 22% and 7%, respectively; there was no significant difference in overall survival between the patients with and without SRE at enrollment. The main BMD treatments were opiate therapy (77.7%), biphosphonates (52.3%), radiotherapy (42.1%), and surgery (9.2%). The mean monthly BMD treatment costs in euros were €190, €374, and €4672 for asymptomatic patients, symptomatic patients, and patients with SRE, respectively. The average first-year BMD management cost in euros was €3999 ± 4135 (95% confidence interval: 374-15,886), and 49.5% of this cost was attributable to patients with SRE. CONCLUSIONS: This analysis confirms the poor prognosis of BMD from lung cancer and underlines the burden of SRE in overall treatment costs.
- Published
- 2011
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