The contribution of cytotoxic chemotherapy to 5-year survival in adult malignancies.

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The following may be of interest to anyone

considering the value of chemotherapy.

Regards,

Gunar

" " " " " " " " " " "

The contribution of cytotoxic chemotherapy to 5-year survival

in adult malignancies.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & list_uids=15630849 & cmd=R\

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1: Clin Oncol (R Coll Radiol). 2004 Dec;16(8):549-60.

Comment in:

Clin Oncol (R Coll Radiol). 2005 Jun;17(4):294.

Department of Radiation Oncology, Northern Sydney Cancer Centre,

Royal North Shore Hospital, Sydney, NSW, Australia.

AIMS: The debate on the funding and availability of cytotoxic drugs

raises questions about the contribution of curative or adjuvant

cytotoxic chemotherapy to survival in adult cancer patients.

MATERIALS AND METHODS:

We undertook a literature search for randomised clinical trials reporting

a 5-year survival benefit attributable solely to cytotoxic chemotherapy in

adult malignancies. The total number of newly diagnosed cancer patients

for 22 major adult malignancies was determined from cancer registry data

in Australia and from the Surveillance Epidemiology and End Results data

in the USA for 1998.

For each malignancy, the absolute number to benefit was the product of

(a) the total number of persons with that malignancy;

( the proportion or subgroup(s) of that malignancy showing a benefit;

© the percentage increase in 5-year survival due solely to cytotoxic

chemotherapy.

The overall contribution was the sum total of the absolute numbers

showing a 5-year survival benefit expressed as a percentage of the total

number for the 22 malignancies.

RESULTS:

The overall contribution of curative and adjuvant cytotoxic chemotherapy

to 5-year survival in adults was estimated to be 2.3% in Australia and

2.1% in the USA.

CONCLUSION:

As the 5-year relative survival rate for cancer in Australia is now over

60%,

it is clear that cytotoxic chemotherapy only makes a minor contribution

to cancer survival. To justify the continued funding and availability of

drugs

used in cytotoxic chemotherapy, a rigorous evaluation of the

cost-effectiveness and impact on quality of life is urgently required.

PMID: 15630849 [PubMed - indexed for MEDLINE]