Factors Impacting Treatment Choice in the First-Line Treatment of Colorectal Cancer.

Bloem, LT; De Abreu Lourenço, R; Chin, M; Ly, B; Haas, M

Factors Impacting Treatment Choice in the First-Line Treatment of Colorectal Cancer.

Bloem, LT De Abreu Lourenço, R Chin, M Ly, B Haas, M

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Publication Type:: Journal Article
Citation:: Oncol Ther, 2016, 4 (1), pp. 103 - 116
Issue Date:: 2016

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Field	Value	Language
dc.contributor.author	Bloem, LT	en_US
dc.contributor.author	De Abreu Lourenço, R	en_US
dc.contributor.author	Chin, M	en_US
dc.contributor.author	Ly, B	en_US
dc.contributor.author	Haas, M https://orcid.org/0000-0002-9726-3063	en_US
dc.date.issued	2016	en_US
dc.identifier.citation	Oncol Ther, 2016, 4 (1), pp. 103 - 116	en_US
dc.identifier.issn	2366-1070	en_US
dc.identifier.uri	http://hdl.handle.net/10453/118962
dc.description.abstract	INTRODUCTION: To investigate the factors that affect the choice of 5-fluorouracil (5-FU) or its oral alternative, capecitabine, as first-line treatment in patients with colorectal cancer (CRC). METHODS: Patients treated with 5-FU or capecitabine for CRC between January 1, 2011 and December 31, 2013 in a teaching hospital in the Sydney metropolitan area, Australia were identified using the hospital's database MOSAIQ®. The electronic medical record of each patient was manually reviewed to extract factors potentially affecting treatment choice. Logistic regression was used to assess which patient and/or treatment factors could explain the choice between 5-FU or capecitabine. Where it was available in the medical correspondence, the explicit reason for the choice made was extracted. RESULTS: 170 CRC patients were included; 119 on 5-FU, and 51 on capecitabine. The odds of receiving capecitabine as a first-line treatment were positively associated with giving patients a choice in the decision (OR = 17.51, 95% CI: 5.37-57.08). Qualitative data suggest treatment choices were motivated by convenience (oral administration) and tolerability. Time from diagnosis to treatment commencement (OR = 1.02 per month, 95% CI 1.00-1.04) was also found to be positively associated with the choice of capecitabine. The odds of being treated with capecitabine were lower for patients who lived further from the treating hospital (OR = 0.22, 95% CI 0.05-0.94). CONCLUSION: This study suggests that patient choice, favoring oral capecitabine over i.v. 5-FU, was a key factor influencing first-line treatment for CRC in this cohort. To respect their autonomy, patients should be involved in the clinical decision making process.	en_US
dc.language	eng	en_US
dc.relation.ispartof	Oncol Ther	en_US
dc.relation.isbasedon	10.1007/s40487-016-0020-4	en_US
dc.title	Factors Impacting Treatment Choice in the First-Line Treatment of Colorectal Cancer.	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	4	en_US
utslib.location.activity	New Zealand	en_US
utslib.for	140208 Health Economics	en_US
utslib.for	1199 Other Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	4	en_US

Abstract:

INTRODUCTION: To investigate the factors that affect the choice of 5-fluorouracil (5-FU) or its oral alternative, capecitabine, as first-line treatment in patients with colorectal cancer (CRC). METHODS: Patients treated with 5-FU or capecitabine for CRC between January 1, 2011 and December 31, 2013 in a teaching hospital in the Sydney metropolitan area, Australia were identified using the hospital's database MOSAIQ®. The electronic medical record of each patient was manually reviewed to extract factors potentially affecting treatment choice. Logistic regression was used to assess which patient and/or treatment factors could explain the choice between 5-FU or capecitabine. Where it was available in the medical correspondence, the explicit reason for the choice made was extracted. RESULTS: 170 CRC patients were included; 119 on 5-FU, and 51 on capecitabine. The odds of receiving capecitabine as a first-line treatment were positively associated with giving patients a choice in the decision (OR = 17.51, 95% CI: 5.37-57.08). Qualitative data suggest treatment choices were motivated by convenience (oral administration) and tolerability. Time from diagnosis to treatment commencement (OR = 1.02 per month, 95% CI 1.00-1.04) was also found to be positively associated with the choice of capecitabine. The odds of being treated with capecitabine were lower for patients who lived further from the treating hospital (OR = 0.22, 95% CI 0.05-0.94). CONCLUSION: This study suggests that patient choice, favoring oral capecitabine over i.v. 5-FU, was a key factor influencing first-line treatment for CRC in this cohort. To respect their autonomy, patients should be involved in the clinical decision making process.

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http://hdl.handle.net/10453/118962