Comparative Effectiveness of Modern Therapies for Localized Prostate Cancer

现代疗法对局限性前列腺癌的比较疗效

• 批准号: 8639188
• 负责人: DAVID F. PENSON
• 金额: $ 84.23万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2016-04-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8639188
• 关键词: Comparative; Effectiveness; Modern; Therapies; Localized

DESCRIPTION (provided by applicant): Prostate Cancer (PCa) is the most common solid tumor among American men and the second leading cause of cancer death. Surgery, radiation and active surveillance (AS) may all be appropriate treatments for men newly diagnosed with localized PCa. The 2008 AHRQ comparative effectiveness report on therapies for localized PCa determined that "no one therapy can be considered the preferred treatment due to the limitations in the body of evidence as well as the likely tradeoffs an individual patient must make between estimated treatment effectiveness, necessity and adverse effects." Simply put, there is a pressing need for additional and better studies on the comparative effectiveness of treatments for localized PCa. In 2010, AHRQ funded the Comparative Effectiveness Analysis of Surgery And Radiation for localized PCa (CEASAR) study. CEASAR consists of a prospective, population-based cohort of 3691 men diagnosed with localized PCa in 2011 who were treated with contemporary therapies, including AS. CEASAR collected baseline patient-reported health-related quality of life, clinical, and sociodemographic data. We then obtained clinical and patient reported outcomes at 6 and 12 months after enrollment. We also performed medical record review at 1 year, collecting clinical information and data on the technical details of the interventions, complications, short-term cancer recurrence rates, and quality-of-care indicators. We will leverage the existing CEASAR study and collect 3- and 5-year follow-up data to: (1) Compare the effectiveness and harms of contemporary surgery, radiation and AS in terms of 3- and 5-year patient-reported outcomes and cancer control. We will identify and analyze outcome "profiles" associated with each therapy that can be used to inform patient specific outcome trajectories when selecting therapy and after treatment. (2) Identify patient-level characteristics that influence the comparative effectiveness and harms of treatment. We will assess the influence of race, co-morbid conditions and socio-economic status on 3- and 5- year patient-reported outcomes in the entire group and in individual treatment groups to identify subgroups of patients who respond uniquely to certain treatments. (3) To evaluate the association of quality of care with clinical and patient-reported outcomes. We will assess the relationship between pre-specified quality indicators and 3- and 5-year outcomes in CEASAR. We will then re-assess the comparative effectiveness of the various treatments, controlling for quality measures found to independently influence outcomes. By understanding what works, in which patients and in whose hands in localized prostate cancer, we will be advancing AHRQ's mission of improving the quality, safety and effectiveness of healthcare in this common condition.

描述（由申请人提供）：前列腺癌（PCA）是美国男性中最常见的实体瘤，也是癌症死亡的第二大原因。手术，辐射和主动监测（AS）可能都是针对新诊断为局部PCA的男性的适当治疗方法。 2008年AHRQ对局部PCA疗法的比较有效性报告确定：“由于证据体内的局限性以及个别患者必须做出的可能的权衡，任何一种疗法都不能被视为首选治疗 between estimated treatment effectiveness, necessity and adverse effects." Simply put, there is a pressing need for additional and better studies on the comparative effectiveness of treatments for localized PCa. In 2010, AHRQ funded the Comparative Effectiveness Analysis of Surgery And Radiation for localized PCa (CEASAR) study. CEASAR consists of a prospective, population-based cohort of 3691 men diagnosed with localized PCa in 2011 who were treated with contemporary therapies, including AS CEASAR收集了与健康相关的生活质量，临床和社会人口统计学的基线。 报名后6和12个月的结果报告。我们还在1年内进行了医疗记录审查，收集了有关干预措施，并发症，短期癌症复发率和护理质量指标的技术细节的临床信息和数据。我们将利用现有的CEASAR研究并收集3年和5年的随访数据来：（1）比较当代手术，放射线的有效性和危害，以及3年和5年患者报告的结果和癌症控制。我们将识别和分析与每种疗法相关的结果“特征”，可用于在选择治疗和治疗后使用特定的特定结果轨迹告知患者。 （2）确定患者级特征 这会影响治疗的比较有效性和危害。我们将评估种族，合并症状况和社会经济状况对整个组和单个治疗组的3年和5年患者报告结果的影响，以识别对某些治疗唯一反应的患者的亚组。 （3）评估护理质量与临床和患者报告的结果的关联。我们将评估Ceasar预先指定的质量指标与3年和5年结局之间的关系。然后，我们将重新评估各种治疗方法的比较有效性，以控制发现独立影响结果的质量措施。 通过了解有效的方法，在哪些患者中以及在局部前列腺癌中手中，我们将促进AHRQ在这种常见状态下提高医疗保健质量，安全性和有效性的使命。