Delivery of chemotherapy for testicular cancer in routine practice: A population-based study
Maintenance of chemotherapy dose intensity is a cornerstone of management in testicular germ cell tumors. We describe chemotherapy delivery and outcomes of patients in routine practice. The Ontario Cancer Registry was linked to electronic records of treatment to identify patients diagnosed with test...
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| Veröffentlicht in: | Urologic oncology 2019-03, Vol.37 (3), p.183.e17-183.e24 |
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| container_title | Urologic oncology |
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| creator | Karim, Safiya Wei, Xuejiao Leveridge, Michael J. Siemens, David Robert Robinson, Andrew G. Bedard, Philippe L. Booth, Christopher M. |
| description | Maintenance of chemotherapy dose intensity is a cornerstone of management in testicular germ cell tumors. We describe chemotherapy delivery and outcomes of patients in routine practice.
The Ontario Cancer Registry was linked to electronic records of treatment to identify patients diagnosed with testicular cancer treated with orchiectomy and chemotherapy from 2005 to 2010. We describe chemotherapy delivery and dose intensity. Overall survival was measured from the start of chemotherapy.
During the study period, 552 new cases of testicular cancer were treated with orchiectomy and chemotherapy; drug/regimen details were available for 475 (86%) cases. The study population included 324 patients with nonseminoma and 151 with seminoma. The majority of patients were treated with bleomycin, etoposide, and cisplatin (BEP) (83%, 394/475) or etoposide and cisplatin (EP) (6%, 30/475); 89% (379/424) received 3 to 4 cycles of treatment. Thirty two percent of all BEP patients (125/394) had at least 1 dose omission of bleomycin; this rate increased to 51% of patients treated with BEP × 4. Eight percent (33/397) of evaluable BEP/EP patients had a dose reduction/omission of cisplatin and 21% (82/397) had a dose delay of >6 days. Among the BEP/EP cases, 44% (174/397) had reduced chemotherapy dose intensity. Five-year overall survival for all cases was 95%.
Almost half of patients treated with BEP/EP chemotherapy in routine practice have some form of reduced chemotherapy delivery. Despite this, long-term survival in the general population is very high. Further studies are required to understand the extent to which dose delivery might influence outcomes. |
| doi_str_mv | 10.1016/j.urolonc.2018.10.025 |
| format | Article |
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The Ontario Cancer Registry was linked to electronic records of treatment to identify patients diagnosed with testicular cancer treated with orchiectomy and chemotherapy from 2005 to 2010. We describe chemotherapy delivery and dose intensity. Overall survival was measured from the start of chemotherapy.
During the study period, 552 new cases of testicular cancer were treated with orchiectomy and chemotherapy; drug/regimen details were available for 475 (86%) cases. The study population included 324 patients with nonseminoma and 151 with seminoma. The majority of patients were treated with bleomycin, etoposide, and cisplatin (BEP) (83%, 394/475) or etoposide and cisplatin (EP) (6%, 30/475); 89% (379/424) received 3 to 4 cycles of treatment. Thirty two percent of all BEP patients (125/394) had at least 1 dose omission of bleomycin; this rate increased to 51% of patients treated with BEP × 4. Eight percent (33/397) of evaluable BEP/EP patients had a dose reduction/omission of cisplatin and 21% (82/397) had a dose delay of >6 days. Among the BEP/EP cases, 44% (174/397) had reduced chemotherapy dose intensity. Five-year overall survival for all cases was 95%.
Almost half of patients treated with BEP/EP chemotherapy in routine practice have some form of reduced chemotherapy delivery. Despite this, long-term survival in the general population is very high. Further studies are required to understand the extent to which dose delivery might influence outcomes.</description><identifier>ISSN: 1078-1439</identifier><identifier>EISSN: 1873-2496</identifier><identifier>DOI: 10.1016/j.urolonc.2018.10.025</identifier><identifier>PMID: 30478011</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject><![CDATA[Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - standards ; Bleomycin - administration & dosage ; Chemotherapy ; Chemotherapy, Adjuvant - statistics & numerical data ; Cisplatin - administration & dosage ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Etoposide - administration & dosage ; Germ cell tumor ; Health services ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasms, Germ Cell and Embryonal - mortality ; Neoplasms, Germ Cell and Embryonal - therapy ; Ontario - epidemiology ; Orchiectomy ; Population-based study ; Practice Guidelines as Topic ; Registries - statistics & numerical data ; Retrospective Studies ; Seminoma - mortality ; Seminoma - therapy ; Testicular cancer ; Testicular Neoplasms - mortality ; Testicular Neoplasms - therapy ; Treatment Outcome ; Young Adult]]></subject><ispartof>Urologic oncology, 2019-03, Vol.37 (3), p.183.e17-183.e24</ispartof><rights>2018 Elsevier Inc.</rights><rights>Copyright © 2018 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-13fa8fed832059204769d3a4c2c963f48e1b6bb1ca89d36203134583ad5b45a53</citedby><cites>FETCH-LOGICAL-c365t-13fa8fed832059204769d3a4c2c963f48e1b6bb1ca89d36203134583ad5b45a53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1078143918304344$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30478011$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karim, Safiya</creatorcontrib><creatorcontrib>Wei, Xuejiao</creatorcontrib><creatorcontrib>Leveridge, Michael J.</creatorcontrib><creatorcontrib>Siemens, David Robert</creatorcontrib><creatorcontrib>Robinson, Andrew G.</creatorcontrib><creatorcontrib>Bedard, Philippe L.</creatorcontrib><creatorcontrib>Booth, Christopher M.</creatorcontrib><title>Delivery of chemotherapy for testicular cancer in routine practice: A population-based study</title><title>Urologic oncology</title><addtitle>Urol Oncol</addtitle><description>Maintenance of chemotherapy dose intensity is a cornerstone of management in testicular germ cell tumors. We describe chemotherapy delivery and outcomes of patients in routine practice.
The Ontario Cancer Registry was linked to electronic records of treatment to identify patients diagnosed with testicular cancer treated with orchiectomy and chemotherapy from 2005 to 2010. We describe chemotherapy delivery and dose intensity. Overall survival was measured from the start of chemotherapy.
During the study period, 552 new cases of testicular cancer were treated with orchiectomy and chemotherapy; drug/regimen details were available for 475 (86%) cases. The study population included 324 patients with nonseminoma and 151 with seminoma. The majority of patients were treated with bleomycin, etoposide, and cisplatin (BEP) (83%, 394/475) or etoposide and cisplatin (EP) (6%, 30/475); 89% (379/424) received 3 to 4 cycles of treatment. Thirty two percent of all BEP patients (125/394) had at least 1 dose omission of bleomycin; this rate increased to 51% of patients treated with BEP × 4. Eight percent (33/397) of evaluable BEP/EP patients had a dose reduction/omission of cisplatin and 21% (82/397) had a dose delay of >6 days. Among the BEP/EP cases, 44% (174/397) had reduced chemotherapy dose intensity. Five-year overall survival for all cases was 95%.
Almost half of patients treated with BEP/EP chemotherapy in routine practice have some form of reduced chemotherapy delivery. Despite this, long-term survival in the general population is very high. Further studies are required to understand the extent to which dose delivery might influence outcomes.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</subject><subject>Antineoplastic Combined Chemotherapy Protocols - standards</subject><subject>Bleomycin - administration & dosage</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Adjuvant - statistics & numerical data</subject><subject>Cisplatin - administration & dosage</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug Administration Schedule</subject><subject>Etoposide - administration & dosage</subject><subject>Germ cell tumor</subject><subject>Health services</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasms, Germ Cell and Embryonal - mortality</subject><subject>Neoplasms, Germ Cell and Embryonal - therapy</subject><subject>Ontario - epidemiology</subject><subject>Orchiectomy</subject><subject>Population-based study</subject><subject>Practice Guidelines as Topic</subject><subject>Registries - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Seminoma - mortality</subject><subject>Seminoma - therapy</subject><subject>Testicular cancer</subject><subject>Testicular Neoplasms - mortality</subject><subject>Testicular Neoplasms - therapy</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>1078-1439</issn><issn>1873-2496</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtOwzAQRS0EgvL4BJCXbFI8tpM6bFBVnlIlNrBDshxnIlylcbATpP49rlrYsrJ154xnfAi5BDYFBsXNajoG3_rOTjkDlbIp4_kBmYCaiYzLsjhMdzZTGUhRnpDTGFeMgVQAx-REMDlTDGBCPu6xdd8YNtQ31H7i2g-fGEy_oY0PdMA4ODu2JlBrOouBuo4GPw6uQ9oHY1MVb-mc9r5P1OB8l1UmYk3jMNabc3LUmDbixf48I--PD2-L52z5-vSymC8zK4p8yEA0RjVYK8FZXvK0W1HWwkjLbVmIRiqEqqgqsEalvOBMgJC5EqbOK5mbXJyR6927ffBfY9pZr1202LamQz9GzUGoQipZ8oTmO9QGH2PARvfBrU3YaGB6K1av9F6s3ordxkls6rvajxirNdZ_Xb8mE3C3AzB99Nth0NE6TM5qF9AOuvbunxE_3x-M-Q</recordid><startdate>201903</startdate><enddate>201903</enddate><creator>Karim, Safiya</creator><creator>Wei, Xuejiao</creator><creator>Leveridge, Michael J.</creator><creator>Siemens, David Robert</creator><creator>Robinson, Andrew G.</creator><creator>Bedard, Philippe L.</creator><creator>Booth, Christopher M.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201903</creationdate><title>Delivery of chemotherapy for testicular cancer in routine practice: A population-based study</title><author>Karim, Safiya ; Wei, Xuejiao ; Leveridge, Michael J. ; Siemens, David Robert ; Robinson, Andrew G. ; Bedard, Philippe L. ; Booth, Christopher M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-13fa8fed832059204769d3a4c2c963f48e1b6bb1ca89d36203134583ad5b45a53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</topic><topic>Antineoplastic Combined Chemotherapy Protocols - standards</topic><topic>Bleomycin - administration & dosage</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Adjuvant - statistics & numerical data</topic><topic>Cisplatin - administration & dosage</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug Administration Schedule</topic><topic>Etoposide - administration & dosage</topic><topic>Germ cell tumor</topic><topic>Health services</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasms, Germ Cell and Embryonal - mortality</topic><topic>Neoplasms, Germ Cell and Embryonal - therapy</topic><topic>Ontario - epidemiology</topic><topic>Orchiectomy</topic><topic>Population-based study</topic><topic>Practice Guidelines as Topic</topic><topic>Registries - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Seminoma - mortality</topic><topic>Seminoma - therapy</topic><topic>Testicular cancer</topic><topic>Testicular Neoplasms - mortality</topic><topic>Testicular Neoplasms - therapy</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karim, Safiya</creatorcontrib><creatorcontrib>Wei, Xuejiao</creatorcontrib><creatorcontrib>Leveridge, Michael J.</creatorcontrib><creatorcontrib>Siemens, David Robert</creatorcontrib><creatorcontrib>Robinson, Andrew G.</creatorcontrib><creatorcontrib>Bedard, Philippe L.</creatorcontrib><creatorcontrib>Booth, Christopher M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Urologic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karim, Safiya</au><au>Wei, Xuejiao</au><au>Leveridge, Michael J.</au><au>Siemens, David Robert</au><au>Robinson, Andrew G.</au><au>Bedard, Philippe L.</au><au>Booth, Christopher M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Delivery of chemotherapy for testicular cancer in routine practice: A population-based study</atitle><jtitle>Urologic oncology</jtitle><addtitle>Urol Oncol</addtitle><date>2019-03</date><risdate>2019</risdate><volume>37</volume><issue>3</issue><spage>183.e17</spage><epage>183.e24</epage><pages>183.e17-183.e24</pages><issn>1078-1439</issn><eissn>1873-2496</eissn><abstract>Maintenance of chemotherapy dose intensity is a cornerstone of management in testicular germ cell tumors. We describe chemotherapy delivery and outcomes of patients in routine practice.
The Ontario Cancer Registry was linked to electronic records of treatment to identify patients diagnosed with testicular cancer treated with orchiectomy and chemotherapy from 2005 to 2010. We describe chemotherapy delivery and dose intensity. Overall survival was measured from the start of chemotherapy.
During the study period, 552 new cases of testicular cancer were treated with orchiectomy and chemotherapy; drug/regimen details were available for 475 (86%) cases. The study population included 324 patients with nonseminoma and 151 with seminoma. The majority of patients were treated with bleomycin, etoposide, and cisplatin (BEP) (83%, 394/475) or etoposide and cisplatin (EP) (6%, 30/475); 89% (379/424) received 3 to 4 cycles of treatment. Thirty two percent of all BEP patients (125/394) had at least 1 dose omission of bleomycin; this rate increased to 51% of patients treated with BEP × 4. Eight percent (33/397) of evaluable BEP/EP patients had a dose reduction/omission of cisplatin and 21% (82/397) had a dose delay of >6 days. Among the BEP/EP cases, 44% (174/397) had reduced chemotherapy dose intensity. Five-year overall survival for all cases was 95%.
Almost half of patients treated with BEP/EP chemotherapy in routine practice have some form of reduced chemotherapy delivery. Despite this, long-term survival in the general population is very high. Further studies are required to understand the extent to which dose delivery might influence outcomes.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30478011</pmid><doi>10.1016/j.urolonc.2018.10.025</doi></addata></record> |
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| ispartof | Urologic oncology, 2019-03, Vol.37 (3), p.183.e17-183.e24 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adolescent Adult Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - standards Bleomycin - administration & dosage Chemotherapy Chemotherapy, Adjuvant - statistics & numerical data Cisplatin - administration & dosage Dose-Response Relationship, Drug Drug Administration Schedule Etoposide - administration & dosage Germ cell tumor Health services Humans Kaplan-Meier Estimate Male Middle Aged Neoplasms, Germ Cell and Embryonal - mortality Neoplasms, Germ Cell and Embryonal - therapy Ontario - epidemiology Orchiectomy Population-based study Practice Guidelines as Topic Registries - statistics & numerical data Retrospective Studies Seminoma - mortality Seminoma - therapy Testicular cancer Testicular Neoplasms - mortality Testicular Neoplasms - therapy Treatment Outcome Young Adult |
| title | Delivery of chemotherapy for testicular cancer in routine practice: A population-based study |
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