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Titolo:
Patient preferences for adjuvant interferon alfa-2b treatment
Autore:
Kilbridge, KL; Weeks, JC; Sober, AJ; Haluska, FG; Slingluff, CL; Atkins, MB; Sock, DE; Kirkwood, JM; Nease, RF;
Indirizzi:
Univ Virginia Hlth Syst, HSC, Dept Hlth Evaluat Sci, Charlottesville, VA 22908 USA Univ Virginia Hlth Syst Charlottesville VA USA 22908 sville, VA 22908 USA Univ Virginia Hlth Syst, Dept Internal Med, Charlottesville, VA 22908 USA Univ Virginia Hlth Syst Charlottesville VA USA 22908 sville, VA 22908 USA Univ Virginia Hlth Syst, Dept Surg, Charlottesville, VA 22908 USA Univ Virginia Hlth Syst Charlottesville VA USA 22908 sville, VA 22908 USA Dana Farber Canc Inst, Ctr OUtcomes & Policy Res, Boston, MA 02115 USA Dana Farber Canc Inst Boston MA USA 02115 olicy Res, Boston, MA 02115 USA Massachusetts Gen Hosp, Dept Dermatol, Boston, MA 02114 USA Massachusetts Gen Hosp Boston MA USA 02114 Dermatol, Boston, MA 02114 USA Massachusetts Gen Hosp, Div Hematol Oncol, Boston, MA 02114 USA Massachusetts Gen Hosp Boston MA USA 02114 ol Oncol, Boston, MA 02114 USA Beth Israel Deaconess Med Ctr, Div Hematol Oncol, Boston, MA 02215 USA Beth Israel Deaconess Med Ctr Boston MA USA 02215 l, Boston, MA 02215 USA Harvard Univ, Sch Med, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 vard Univ, Sch Med, Boston, MA 02115 USA Univ Pittsburgh, Div Med Oncol, Pittsburgh, PA USA Univ Pittsburgh Pittsburgh PA USA rgh, Div Med Oncol, Pittsburgh, PA USA Washington Univ, Sch Med, Lab Med Decis Sci, St Louis, MO USA Washington Univ St Louis MO USA Med, Lab Med Decis Sci, St Louis, MO USA
Titolo Testata:
JOURNAL OF CLINICAL ONCOLOGY
fascicolo: 3, volume: 19, anno: 2001,
pagine: 812 - 823
SICI:
0732-183X(20010201)19:3<812:PPFAIA>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
METASTATIC MALIGNANT-MELANOMA; RESECTED CUTANEOUS MELANOMA; COOPERATIVE-ONCOLOGY-GROUP; PHASE-II TRIAL; MULTIFACTORIAL ANALYSIS; PROGNOSTIC FACTORS; SURVIVAL; HEALTH;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Kilbridge, KL Univ Virginia Hlth Syst, HSC, Dept Hlth Evaluat Sci, POB 800821, Charlottesville, VA 22908 USA Univ Virginia Hlth Syst POB 800821 Charlottesville VA USA 22908
Citazione:
K.L. Kilbridge et al., "Patient preferences for adjuvant interferon alfa-2b treatment", J CL ONCOL, 19(3), 2001, pp. 812-823

Abstract

Purpose: Although trials of adjuvant interferon alfa-2b (IFN alpha -2b) inhigh-risk melanoma patients suggest improvement in disease-free survival, it is unclear whether treatment offers improvement in overall survival. Widespread use of adjuvant IFN alpha -2b has been tempered by its significant toxicity. To quantify the trade-offs between IFN alpha -2b toxicity and survival, we assessed patient utilities for health states associated with IFN therapy. Utilities are measures of preference for a particular health stateon a scale of 0 (death) to 1 (perfect health). Patients and Methods: We assessed utilities for health states associated with adjuvant IFN among 107 low-risk melanoma patients using the standard gamble technique. Health states described four IFN alpha -2b Sb toxicity scenarios and the following three posttreatment outcomes: disease-free health and melanoma recurrence (with or without IFN alpha -2b) leading to cancer death. We also asked patients the improvement in 5-year disease-free survivalthey would require to tolerate IFN. Results: Utilities for melanoma recurrence with or without IFN alpha -2b were significantly lower than utilities for all IFN alpha -2b toxicities butwere not significantly different from each other. At least half of the patients were willing to tolerate mild-moderate and severe IFN alpha -2b toxicity for 4% and 10% improvements, respectively, in 5-year disease free survival. Conclusion: On average, patients rate quality of life with melanoma recurrence much lower than even severe IFN alpha- 2b toxicity. These results suggest that recurrence-free survival is highly valued by patients. The utilities measured in our study can be applied directly to quality-of-life determinations in clinical trials of adjuvant IFN alpha -2b to measure the net benefit of therapy. (C) 2001 by American Society of Clinical Oncology.

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Documento generato il 25/11/20 alle ore 10:24:59