Association of significant financial burden with survival for head and neck cancer patients treated with radiation therapy.

Cost of Illness Female Head and Neck Neoplasms / economics Humans Male Middle Aged Radiotherapy, Adjuvant / methods Retrospective Studies
Financial support Head and neck neoplasms Kaplan-Meier Analysis Matched-pair analysis Oral cancer Survival

Journal

Oral oncology
ISSN: 1879-0593
Titre abrégé: Oral Oncol
Pays: England
ID NLM: 9709118

Informations de publication

Date de publication:
04 2021
Historique:
received: 07 08 2020
revised: 04 01 2021
accepted: 17 01 2021
pubmed: 13 2 2021
medline: 18 11 2021
entrez: 12 2 2021
Statut: ppublish

Résumé

To assess the association between financial toxicity and survival in patients with head and neck cancer (HNC). Using a single-institution database, we retrospectively reviewed HNC patients treated at Roswell Park Comprehensive Cancer Center treated with definitive or postoperative radiation therapy between 2013 and 2017. Kaplan-Meier method and log-rank tests were used to analyze survival outcomes. Propensity score matching on all clinically relevant baseline characteristics was performed to address selection bias. All statistical tests were two-sided and those less than 0.05 were considered statistically significant. Of a total of 284 HNC patients (age: median 61 years, IQR 55-67; 220 [77.5%] men), 204 patients (71.8%) received definitive radiation and 80 patients (28.2%) received adjuvant radiation. There were 41 patients (14.4%) who reported high baseline financial toxicity. Chemotherapy was used in 237 patients (83.5%). On multivariable analysis, those with high financial toxicity exhibited worse overall survival (hazards ratio [HR] 1.75, 95% confidence interval [CI] 1.05-2.94, p = 0.03) and cancer specific survival (HR 2.28, 95% CI 1.31-3.96, p = 0.003). On matched pair analysis of 66 patients, high financial toxicity remained associated with worse OS (HR 2.72, 95% CI 1.04-7.09, p = 0.04) and CSS (HR 3.75, 95% CI 1.22-11.5, p = 0.02). HNC patient reported baseline financial toxicity was significantly correlated with both decreased overall and cancer specific survival. These significant correlations held after match pairing. Further research is warranted to investigate the impact of financial toxicity in HNC and mitigate its risk.

Identifiants

DOI: 10.1016/j.oraloncology.2021.105196 PMID: 33578203 PMC: PMC10353569
pubmed: 33578203
pii: S1368-8375(21)00019-1
doi: 10.1016/j.oraloncology.2021.105196
pmc: PMC10353569
mid: NIHMS1898874
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105196

Subventions

Organisme : NCI NIH HHS
ID : P30 CA016056
Pays : United States

Informations de copyright

Copyright © 2021 Elsevier Ltd. All rights reserved.

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Auteurs

Sung Jun Ma (SJ)

Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA; Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY 14203, USA. Electronic address: Sungjun.Ma@roswellpark.org.

Austin J Iovoli (AJ)

Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA; Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY 14203, USA. Electronic address: Austin.Iovoli@roswellpark.org.

Kristopher Attwood (K)

Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Kristopher.Attwood@roswellpark.org.

Kimberly E Wooten (KE)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Kimberly.Wooten@roswellpark.org.

Hassan Arshad (H)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Hassan.Arshad@roswellpark.org.

Vishal Gupta (V)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Vishal.Gupta@roswellpark.org.

Ryan P McSpadden (RP)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Ryan.McSpadden@roswellpark.org.

Moni A Kuriakose (MA)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Moni.Kuriakose@roswellpark.org.

Michael R Markiewicz (MR)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA; Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University at Buffalo, The State University of New York, 3435 Main Street, Buffalo, NY 14214, USA; Department of Neurosurgery, Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY 14203, USA. Electronic address: Michael.Markiewicz@roswellpark.org.

Jon M Chan (JM)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Jon.Chan@roswellpark.org.

Wesley L Hicks (WL)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Wesley.Hicks@roswellpark.org.

Mary E Platek (ME)

Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA; Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA; Department of Dietetics, D'Youville College, 270 Porter Avenue, Buffalo, NY 14201, USA. Electronic address: Mary.Platek@roswellpark.org.

Andrew D Ray (AD)

Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Andrew.Ray@roswellpark.org.

Elizabeth A Repasky (EA)

Department of Immunology, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Elizabeth.Repasky@roswellpark.org.

Mark K Farrugia (MK)

Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Mark.Farrugia@Roswellpark.org.

Anurag K Singh (AK)

Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Anurag.Singh@roswellpark.org.

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Classifications MeSH

questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enquêtes et questionnaires › Enquêtes de santé › Indicateurs d'état de santé › Coûts indirects de la maladie › Association of significant financial burden...
questionsmedicales.fr › Tumeurs › Tumeurs par siège › Tumeurs de la tête et du cou › Association of significant financial burden...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Association of significant financial burden...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Association of significant financial burden...
questionsmedicales.fr › Thérapeutique › Radiothérapie › Radiothérapie adjuvante › Association of significant financial burden...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Association of significant financial burden...