Is comparative effectiveness research effective ? Abandonment of high dose chemotherapy / hematopoietic cell transplants for breast cancer
نویسندگان
چکیده
We examine the impact of negative clinical trial results on use of autologous hematopoietic cell transplantation (HDC/HCT) in breast cancer patients. Abandonment of occurred rapidly; one year after the results became public, volume was 20% of the 1998 peak. Teaching and research hospitals were slower to discontinue the procedure, and the pattern of decline suggests that hospitals passively abandoned HDC/HCT as demand declined rather than actively deciding to discontinue offering HDC/HCT to patients. Please send comments to: [email protected] We thank Steven Joffe for comments on an earlier draft of the paper.
منابع مشابه
Abandonment of high-dose chemotherapy/hematopoietic cell transplants for breast cancer following negative trial results.
OBJECTIVE In 1999, three randomized controlled trials concluded that high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (HDC/HCT) is no better than conventional chemotherapy for women with breast cancer. This study documents the impact of the trials on use of HDC/HCT and describes how hospitals reacted to the trials. DATA SOURCE We used patient-level data on...
متن کاملFeasibility of high-dose iodine-131-metaiodobenzylguanidine therapy for high-risk neuroblastoma preceding myeloablative chemotherapy and hematopoietic stem cell transplantation: a study protocol
Objective(s): High-risk neuroblastoma is a childhood cancer with poorprognosis despite modern multimodality therapy. Internal radiotherapy using131I-metaiodobenzylguanidine (MIBG) is effective for treating the disease even if it isresistant to chemotherapy. The aim of this study is to evaluate the safety and efficacyof 131I-MIBG radiotherapy combined with myeloablative high-dose chemotherapyand...
متن کاملEffectiveness of Acceptance and Commitment Therapy on Hope in Women With Breast Cancer Undergoing Chemotherapy
Objective: The present research aimed to assess the effectiveness of Acceptance and Commitment Therapy (ACT) on the hope of patients with breast cancer undergoing chemotherapy. Methods: In this quasi-experimental study, 30 patients with breast cancer were selected by convenience sampling method and randomly assigned to experimental and control groups. The experimental group attended ACT sessio...
متن کاملBreast cancer cells are effectively purged from peripheral blood progenitor cells with an immunomagnetic technique.
Peripheral blood progenitor cells (PBPCs) are being used increasingly to provide hematopoietic support after intensive chemotherapy. However, many investigators have detected tumor cells contaminating PBPC collections. Methods that eliminate the tumor cells and spare the normal hematopoietic progenitor cells may improve the number of long-term, disease-free survivors after intensive chemotherap...
متن کاملPrognostic analysis of early lymphocyte recovery in patients with advanced breast cancer receiving high-dose chemotherapy with an autologous hematopoietic progenitor cell transplant.
PURPOSE The purpose of this study was to evaluate the prognostic effect of early posttransplant lymphocyte recovery in patients with advanced breast cancer receiving high-dose chemotherapy with autologous hematopoietic progenitor cell transplantation. EXPERIMENTAL DESIGN We analyzed the effect of the absolute lymphocyte count on day +15 posttransplant on freedom from relapse and overall survi...
متن کامل