Efficacy, compliance and reasons for refusal of postoperative chemotherapy for elderly patients with colorectal cancer: a retrospective chart review and telephone patient questionnaire
Numerous clinical trials have demonstrated that elderly patients with colorectal cancer (CRC) can benefit from chemotherapy, yet compliance in real-world practice is low. The purpose of this study is to investigate the efficacy, compliance and reasons for refusal of postoperative chemotherapy for el...
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| Veröffentlicht in: | PloS one 2013-02, Vol.8 (2), p.e55494-e55494 |
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| description | Numerous clinical trials have demonstrated that elderly patients with colorectal cancer (CRC) can benefit from chemotherapy, yet compliance in real-world practice is low. The purpose of this study is to investigate the efficacy, compliance and reasons for refusal of postoperative chemotherapy for elderly patients with CRC and to provide corresponding strategies.
The clinico-pathological and biochemical data of the chemotherapy group and chemo-refusing group were compared among 386 elderly patients (>70 years old) with CRC who underwent surgery. 226 patients received chemotherapy and 160 patients refused. Follow-up of the subjective reasons for refusal was investigated using the elderly caner patients' chemo-refusal reason questionnaire (ECPCRRQ) prepared by the authors and a group of psychologists. The questionnaire is administrated by telephone. A predictive model for 5-year disease-free survival (DFS) and 5-year overall survival (OS) was constructed by using Kaplan-Meier analysis, logistic and Cox regression.
Among stage III patients, receiving chemotherapy was associated with a significantly higher OS (68%) compared to those who refused ( OS 50%) (HR: 2.05, 95%CI: 1.12-3.77, P = 0.02). The Chemo-refusal group had more female and elderly patients, significantly higher rate of severe complications, and lower body mass index (BMI). Follow-up phone questionnaire analysis showed the doctors' uncertainty of chemotherapy benefit, economic difficulties, uncomfortable feeling, superstition of Traditional Chinese Medicine, concealing information and lack of social support were the main factors for elderly CRC patients to decline chemotherapy.
The receipt of post-operative chemotherapy in elderly patients with resected stage III CRC was associated with a more favorable survival. The low compliance rate (160/386) of postoperative chemotherapy was influenced by various subjective and objective factors. |
| doi_str_mv | 10.1371/journal.pone.0055494 |
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The clinico-pathological and biochemical data of the chemotherapy group and chemo-refusing group were compared among 386 elderly patients (>70 years old) with CRC who underwent surgery. 226 patients received chemotherapy and 160 patients refused. Follow-up of the subjective reasons for refusal was investigated using the elderly caner patients' chemo-refusal reason questionnaire (ECPCRRQ) prepared by the authors and a group of psychologists. The questionnaire is administrated by telephone. A predictive model for 5-year disease-free survival (DFS) and 5-year overall survival (OS) was constructed by using Kaplan-Meier analysis, logistic and Cox regression.
Among stage III patients, receiving chemotherapy was associated with a significantly higher OS (68%) compared to those who refused ( OS 50%) (HR: 2.05, 95%CI: 1.12-3.77, P = 0.02). The Chemo-refusal group had more female and elderly patients, significantly higher rate of severe complications, and lower body mass index (BMI). Follow-up phone questionnaire analysis showed the doctors' uncertainty of chemotherapy benefit, economic difficulties, uncomfortable feeling, superstition of Traditional Chinese Medicine, concealing information and lack of social support were the main factors for elderly CRC patients to decline chemotherapy.
The receipt of post-operative chemotherapy in elderly patients with resected stage III CRC was associated with a more favorable survival. The low compliance rate (160/386) of postoperative chemotherapy was influenced by various subjective and objective factors.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0055494</identifier><identifier>PMID: 23451026</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Aged ; Aged, 80 and over ; Body mass ; Body mass index ; Body size ; Cancer ; Cancer patients ; Cancer therapies ; Chemotherapy ; Clinical trials ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - drug therapy ; Colorectal Neoplasms - mortality ; Colorectal Neoplasms - surgery ; Colorectal surgery ; Comparative analysis ; Complications ; Drug dosages ; Economic analysis ; Elderly patients ; Female ; Geriatrics ; Humans ; Kaplan-Meier Estimate ; Male ; Medical personnel ; Medical research ; Medicine ; Metastasis ; Older people ; Patient compliance ; Patients ; Physicians ; Postoperative Period ; Psychologists ; Questionnaires ; Radiation therapy ; Regression analysis ; Retrospective Studies ; Social interactions ; Studies ; Surgery ; Surveys ; Surveys and Questionnaires ; Survival ; Survival analysis ; Systematic review ; Telephone ; Traditional Chinese medicine ; Treatment Refusal - statistics & numerical data</subject><ispartof>PloS one, 2013-02, Vol.8 (2), p.e55494-e55494</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Li et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Li et al 2013 Li et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-72ebf2f0fcd174f36bfceb8426a9347246933d6999c9739d368ffc629e8c010d3</citedby><cites>FETCH-LOGICAL-c692t-72ebf2f0fcd174f36bfceb8426a9347246933d6999c9739d368ffc629e8c010d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579821/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579821/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,2098,2917,23849,27907,27908,53774,53776,79351,79352</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23451026$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Aggarwal, Bharat B.</contributor><creatorcontrib>Li, Pan</creatorcontrib><creatorcontrib>Li, Fen</creatorcontrib><creatorcontrib>Fang, Yujing</creatorcontrib><creatorcontrib>Wan, Desen</creatorcontrib><creatorcontrib>Pan, Zhizhong</creatorcontrib><creatorcontrib>Chen, Gong</creatorcontrib><creatorcontrib>Ma, Gang</creatorcontrib><title>Efficacy, compliance and reasons for refusal of postoperative chemotherapy for elderly patients with colorectal cancer: a retrospective chart review and telephone patient questionnaire</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Numerous clinical trials have demonstrated that elderly patients with colorectal cancer (CRC) can benefit from chemotherapy, yet compliance in real-world practice is low. The purpose of this study is to investigate the efficacy, compliance and reasons for refusal of postoperative chemotherapy for elderly patients with CRC and to provide corresponding strategies.
The clinico-pathological and biochemical data of the chemotherapy group and chemo-refusing group were compared among 386 elderly patients (>70 years old) with CRC who underwent surgery. 226 patients received chemotherapy and 160 patients refused. Follow-up of the subjective reasons for refusal was investigated using the elderly caner patients' chemo-refusal reason questionnaire (ECPCRRQ) prepared by the authors and a group of psychologists. The questionnaire is administrated by telephone. A predictive model for 5-year disease-free survival (DFS) and 5-year overall survival (OS) was constructed by using Kaplan-Meier analysis, logistic and Cox regression.
Among stage III patients, receiving chemotherapy was associated with a significantly higher OS (68%) compared to those who refused ( OS 50%) (HR: 2.05, 95%CI: 1.12-3.77, P = 0.02). The Chemo-refusal group had more female and elderly patients, significantly higher rate of severe complications, and lower body mass index (BMI). Follow-up phone questionnaire analysis showed the doctors' uncertainty of chemotherapy benefit, economic difficulties, uncomfortable feeling, superstition of Traditional Chinese Medicine, concealing information and lack of social support were the main factors for elderly CRC patients to decline chemotherapy.
The receipt of post-operative chemotherapy in elderly patients with resected stage III CRC was associated with a more favorable survival. The low compliance rate (160/386) of postoperative chemotherapy was influenced by various subjective and objective factors.</description><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Clinical trials</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - drug therapy</subject><subject>Colorectal Neoplasms - mortality</subject><subject>Colorectal Neoplasms - surgery</subject><subject>Colorectal surgery</subject><subject>Comparative analysis</subject><subject>Complications</subject><subject>Drug dosages</subject><subject>Economic analysis</subject><subject>Elderly patients</subject><subject>Female</subject><subject>Geriatrics</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Metastasis</subject><subject>Older people</subject><subject>Patient compliance</subject><subject>Patients</subject><subject>Physicians</subject><subject>Postoperative Period</subject><subject>Psychologists</subject><subject>Questionnaires</subject><subject>Radiation therapy</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Social interactions</subject><subject>Studies</subject><subject>Surgery</subject><subject>Surveys</subject><subject>Surveys and Questionnaires</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Systematic review</subject><subject>Telephone</subject><subject>Traditional Chinese medicine</subject><subject>Treatment Refusal - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Pan</au><au>Li, Fen</au><au>Fang, Yujing</au><au>Wan, Desen</au><au>Pan, Zhizhong</au><au>Chen, Gong</au><au>Ma, Gang</au><au>Aggarwal, Bharat B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy, compliance and reasons for refusal of postoperative chemotherapy for elderly patients with colorectal cancer: a retrospective chart review and telephone patient questionnaire</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-02-22</date><risdate>2013</risdate><volume>8</volume><issue>2</issue><spage>e55494</spage><epage>e55494</epage><pages>e55494-e55494</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Numerous clinical trials have demonstrated that elderly patients with colorectal cancer (CRC) can benefit from chemotherapy, yet compliance in real-world practice is low. The purpose of this study is to investigate the efficacy, compliance and reasons for refusal of postoperative chemotherapy for elderly patients with CRC and to provide corresponding strategies.
The clinico-pathological and biochemical data of the chemotherapy group and chemo-refusing group were compared among 386 elderly patients (>70 years old) with CRC who underwent surgery. 226 patients received chemotherapy and 160 patients refused. Follow-up of the subjective reasons for refusal was investigated using the elderly caner patients' chemo-refusal reason questionnaire (ECPCRRQ) prepared by the authors and a group of psychologists. The questionnaire is administrated by telephone. A predictive model for 5-year disease-free survival (DFS) and 5-year overall survival (OS) was constructed by using Kaplan-Meier analysis, logistic and Cox regression.
Among stage III patients, receiving chemotherapy was associated with a significantly higher OS (68%) compared to those who refused ( OS 50%) (HR: 2.05, 95%CI: 1.12-3.77, P = 0.02). The Chemo-refusal group had more female and elderly patients, significantly higher rate of severe complications, and lower body mass index (BMI). Follow-up phone questionnaire analysis showed the doctors' uncertainty of chemotherapy benefit, economic difficulties, uncomfortable feeling, superstition of Traditional Chinese Medicine, concealing information and lack of social support were the main factors for elderly CRC patients to decline chemotherapy.
The receipt of post-operative chemotherapy in elderly patients with resected stage III CRC was associated with a more favorable survival. The low compliance rate (160/386) of postoperative chemotherapy was influenced by various subjective and objective factors.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23451026</pmid><doi>10.1371/journal.pone.0055494</doi><tpages>e55494</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2013-02, Vol.8 (2), p.e55494-e55494 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1351360157 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Age Aged Aged, 80 and over Body mass Body mass index Body size Cancer Cancer patients Cancer therapies Chemotherapy Clinical trials Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - drug therapy Colorectal Neoplasms - mortality Colorectal Neoplasms - surgery Colorectal surgery Comparative analysis Complications Drug dosages Economic analysis Elderly patients Female Geriatrics Humans Kaplan-Meier Estimate Male Medical personnel Medical research Medicine Metastasis Older people Patient compliance Patients Physicians Postoperative Period Psychologists Questionnaires Radiation therapy Regression analysis Retrospective Studies Social interactions Studies Surgery Surveys Surveys and Questionnaires Survival Survival analysis Systematic review Telephone Traditional Chinese medicine Treatment Refusal - statistics & numerical data |
| title | Efficacy, compliance and reasons for refusal of postoperative chemotherapy for elderly patients with colorectal cancer: a retrospective chart review and telephone patient questionnaire |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-16T18%3A15%3A50IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Efficacy,%20compliance%20and%20reasons%20for%20refusal%20of%20postoperative%20chemotherapy%20for%20elderly%20patients%20with%20colorectal%20cancer:%20a%20retrospective%20chart%20review%20and%20telephone%20patient%20questionnaire&rft.jtitle=PloS%20one&rft.au=Li,%20Pan&rft.date=2013-02-22&rft.volume=8&rft.issue=2&rft.spage=e55494&rft.epage=e55494&rft.pages=e55494-e55494&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0055494&rft_dat=%3Cgale_plos_%3EA478167162%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1351360157&rft_id=info:pmid/23451026&rft_galeid=A478167162&rft_doaj_id=oai_doaj_org_article_4b08de643e9a4b0a8483d2bdf1f8edc1&rfr_iscdi=true |