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Title: Chemotherapy in patients with unresected pancreatic cancer in Australia: A population-based study of uptake and survival
Authors: Dumbrava MI; Burmeister EA; Wyld D; Goldstein D; O'Connell DL; Beesley VL; Gooden HM; Janda M; Jordan SJ; Merrett ND; Payne ME; Waterhouse MA; Neale RE
Categories: Cancer Control, Survivorship, and Outcomes Research - Surveillance
Cancer Type - Pancreatic Cancer
Year: 2018
Journal Title: Asia-Pacific Journal of Clinical Oncology
Volume: 14
Issue: 4
Page number start: 326
Page number end: 336
Abstract: 1 Aim Palliative chemotherapy improves symptom control and prolongs survival in patients with unresectable pancreatic cancer, but there is a paucity of data describing its use and effectiveness in everyday practice. We explored patterns of chemotherapy use in patients with unresected pancreatic cancer in Australia and the impact of use on survival. 2 Methods We reviewed the medical records of residents of New South Wales or Queensland, Australia, diagnosed with unresectable pancreatic adenocarcinoma between July 2009 and June 2011. Associations between receipt of chemotherapy and sociodemographic, clinical and health service factors were evaluated using logistic regression. We used Cox proportional hazards models to analyze associations between chemotherapy use and survival. 3 Results Data were collected for 1173 eligible patients. Chemotherapy was received by 44% (n = 184/414) of patients with localized pancreatic cancer and 53% (n = 406/759) of patients with metastases. Chemotherapy receipt depended on clinical factors, such as performance status and comorbidity burden, and nonclinical factors, such as age, place of residence, multidisciplinary team review and the type of specialist first encountered. Consultation with an oncologist mitigated most of the sociodemographic and service‐related disparities in chemotherapy use. The receipt of chemotherapy was associated with prolonged survival in patients with inoperable pancreatic cancer, including after adjusting for common prognostic factors. 4 Conclusions These findings highlight the need to establish referral pathways to ensure that all patients have the opportunity to discuss treatment options with a medical oncologist. This is particularly relevant for health care systems covering areas with a geographically dispersed population.
Division: Cancer Research Division
Funding Body: National Health and Medical Research Council. Grant Number: 613654
DOI: https://doi.org/10.1111/ajco.12862
URI: http://researchpubs.cancercouncil.com.au/cancercounciljspui/handle/1/2020
Appears in Collections:Research Articles

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