1. Patterns of prescribing radiotherapy and bevacizumab in nationwide practice – analysis of 101 designated cancer care hospitals in Japan
- Author
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Yoichiro Tsukada, Takahiro Higashi, Atsuro Terahara, Momoko Iwamoto, and Fumiaki Nakamura
- Subjects
Male ,Vascular Endothelial Growth Factor A ,medicine.medical_specialty ,Bevacizumab ,Health, Toxicology and Mutagenesis ,medicine.medical_treatment ,Cancer Care Facilities ,bevacizumab ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Internal medicine ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Practice Patterns, Physicians' ,Medical prescription ,Intensive care medicine ,Lung cancer ,Adverse effect ,Aged ,Radiation ,Dose-Response Relationship, Drug ,Radiotherapy ,business.industry ,Cancer ,Middle Aged ,medicine.disease ,Cancer registry ,Radiation therapy ,Prescriptions ,030220 oncology & carcinogenesis ,adverse effects ,Female ,radiation-sensitizing agents ,business ,Clinical Radiation Oncology ,medicine.drug - Abstract
Radiotherapy and bevacizumab are each effective in treating patients with advanced cancer, but their concurrent use may cause serious adverse events (SAEs). Whereas sequential administration can theoretically reduce the risk of SAEs while maintaining the anticancer effects, this hypothesis remains unconfirmed, leading to variations in practice. To elucidate current practices, the patterns of care received by patients in Japan with regard to these two therapies were assessed in a large database of a hospital-based cancer registry linked with insurance claims. This database contained information on 106 057 patients diagnosed with seven major cancers in 2011 and the care they received up to the end of 2012. In total, 335 patients from 101 hospitals in the database were treated with both radiotherapy and bevacizumab. Of these patients, 50.8% had lung cancer, and 51.3% had Stage IV cancer. Of the 335 patients, 75 (22.4%) received these therapies concurrently. In patients treated sequentially, the time from the last dose of bevacizumab to the start of radiotherapy was most frequently 4–5 weeks (12.4%), whereas the time from the end of radiotherapy to the start of bevacizumab was most frequently 1–2 weeks (10.6%). The cumulative proportions of patients in these two groups receiving sequential therapies within 3 weeks were 19.0% and 26.1%, respectively. Many practices appeared to avoid the concurrent use of bevacizumab and radiation, but some provided concurrent therapy. Additional data are required to determine whether the avoidance of concurrent use should become a standard of care.
- Published
- 2015