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61.
Background
Infertility is common and in vitro fertilization (IVF) is a widely used treatment. In IVF the need increases and the effectiveness and appropriateness decrease by age. The purpose of this study was to describe allocation of resources for IVF by women's age, socioeconomic position, area of residence and treatment sector (public vs. private) and to discuss how fairly the IVF resources are allocated in Finland. 相似文献62.
Dominik Paul Modest Fernando Rivera Jean-Baptiste Bachet Filippo de Braud Filippo Pietrantonio Reija Koukakis Gaston Demonty Jean-Yves Douillard 《International journal of cancer. Journal international du cancer》2019,145(2):576-585
Panitumumab is approved for RAS wild-type metastatic colorectal cancer and was evaluated in Phase III (PRIME, NCT00364013) and Phase II (PEAK, NCT00819780) first-line randomised studies. This retrospective analysis of these trials investigated efficacy and toxicity of panitumumab-based maintenance after oxaliplatin discontinuation in RAS wild-type patients. First-line regimens were FOLFOX4 ± panitumumab in PRIME and mFOLFOX6 plus panitumumab or mFOLFOX6 plus bevacizumab in PEAK. Outcomes included median progression-free survival (PFS) and overall survival (OS), from randomisation and oxaliplatin discontinuation, and toxicity. Overall, median duration of panitumumab plus 5-fluorouracil/leucovorin (5-FU/LV) maintenance was 21 (interquartile range: 11–41) weeks; that of 5-FU/LV ± bevacizumab maintenance was 16 (6–31) weeks. Median OS from randomisation was 40.2 (95% confidence interval: 30.3–50.4) and 39.1 (34.2–63.0) months for panitumumab plus 5-FU/LV maintenance and 24.1 (17.7–33.0) and 28.9 (21.0–32.0) months for 5-FU/LV ± bevacizumab maintenance in PRIME and PEAK, respectively. Median PFS from randomisation was 16.6 (11.3–23.6) and 15.4 (11.6–18.4) months for panitumumab plus 5-FU/LV maintenance and 12.6 (9.4–16.2) and 13.1 (9.5–16.6) months for 5-FU/LV ± bevacizumab maintenance in PRIME and PEAK, respectively. From oxaliplatin discontinuation, median OS was 33.9 (24.7–42.8) and 33.5 (24.5–54.9) months for panitumumab plus 5-FU/LV maintenance and 16.4 (12.4–24.1) and 23.3 (15.7–26.3) months for 5-FU/LV ± bevacizumab maintenance in PRIME and PEAK, respectively; PFS was 11.7 (7.8–19.2) and 9.7 (5.8–14.8) months and 7.1 (5.6–10.2) and 7.0 (3.9–10.6) months, respectively. The most frequently reported adverse events were rash, fatigue and diarrhoea. Maintenance of panitumumab plus 5-FU/LV after oxaliplatin discontinuation was well tolerated and may be an acceptable treatment paradigm for patients demonstrating a good response to first-line treatment. Prospective studies are warranted. 相似文献
63.
Salvatore Siena Fernando Rivera Julien Taieb Marc Peeters Hans Prenen Reija Koukakis Gaston Demonty Claus-Henning Köhne 《Clinical colorectal cancer》2018,17(1):50-57.e8
Background
Köhne prognostic score is used to classify patients with metastatic colorectal cancer (mCRC) as high, intermediate, or low risk. Using data from 2 phase III trials, we analyzed survival in patients categorized according to Köhne prognostic category and virus-induced rapidly accelerated fibrosarcoma murine sarcoma viral oncogene homolog B (BRAF) mutation.Patients and Methods
PRIME (Panitumumab Randomized Trial In Combination With Chemotherapy for Metastatic Colorectal Cancer to Determine Efficacy) (first-line) and 20050181 (second-line) were studies of chemotherapy with or without panitumumab. Progression-free survival (PFS) and overall survival (OS) were analyzed retrospectively in rat sarcoma viral oncogene homolog (RAS) wild type (WT) and RAS WT+BRAF WT mCRC in each Köhne category, and in BRAF mutant (MT) mCRC.Results
In PRIME (n = 495) and 20050181 (n = 420), 53 (11%) and 44 (10%) patients, respectively, had BRAF MT mCRC. Of the RAS WT+BRAF WT/unknown populations, 85/267/90 and 82/211/83 were categorized as high/medium/low risk, respectively. PFS and OS hazard ratios (HRs), adjusted for Köhne group, for patients with RAS WT + BRAF WT/unknown mCRC favored panitumumab with chemotherapy versus chemotherapy alone in both studies. In PRIME, the PFS HR was 0.74 (95% confidence interval [CI], 0.61-0.90) and OS HR was 0.78 (95% CI, 0.64-0.95). In 20050181, PFS and OS HRs were 0.80 (95% CI, 0.65-0.99) and 0.78 (95% CI, 0.62-0.99), respectively. Median PFS and OS were lower in patients with BRAF MT mCRC than in any of the 3 risk categories for patients with RAS WT+BRAF WT/unknown mCRC.Conclusion
During first- and second-line treatment, Köhne prognostic score allows accurate risk classification in RAS WT mCRC. BRAF MT mCRC should be classified as high risk regardless of other parameters. Panitumumab with chemotherapy might provide survival benefits versus chemotherapy alone in RAS WT and RAS WT+BRAF WT/unknown mCRC, overall and across risk categories. 相似文献64.
65.
Nele Boeckx Reija Koukakis Ken Op de Beeck Christian Rolfo Guy Van Camp Salvatore Siena Josep Tabernero Jean-Yves Douillard Thierry André Marc Peeters 《Clinical colorectal cancer》2018,17(3):170-178.e3
Background
The primary tumor location has a prognostic impact in metastatic colorectal cancer (mCRC). We report the results from retrospective analyses assessing the effect of tumor location on prognosis and efficacy of second- and later-line panitumumab treatment in patients with RAS wild-type (WT) mCRC and on prognosis in all lines of treatment in patients with RAS mutant (MT) mCRC.Patients and Methods
RAS WT data (n = 483) from 2 randomized phase III panitumumab trials (ClinicalTrials.gov identifiers, NCT00339183 and NCT00113763) were analyzed for treatment outcomes stratified by tumor location. The second analysis assessed the effect of tumor location in RAS MT patients (n = 1205) from 4 panitumumab studies (ClinicalTrials.gov identifiers, NCT00364013, NCT00819780, NCT00339183, and NCT00113763). Primary tumors located in the cecum to transverse colon were coded as right-sided; those located from the splenic flexure to the rectum were coded as left-sided.Results
Of all patients, the tumor location was ascertained for 83% to 88%; 71% to 77% of patients had left-sided tumors. RAS WT patients with right-sided tumors did worse for all efficacy parameters compared with those with left-sided tumors. The patients with left-sided tumors had better outcomes with panitumumab than with the comparator treatment. Because of the low patient numbers, no conclusions could be drawn for right-sided mCRC. The prognostic effect of tumor location on survival was unclear for RAS MT patients.Conclusion
These retrospective analyses have confirmed that RAS WT right-sided mCRC is associated with a poor prognosis, regardless of the treatment. RAS WT patients with left-sided tumors benefitted from the addition of panitumumab in second or later treatment lines. Further research is warranted to determine the optimum management of right-sided mCRC and RAS MT tumors. 相似文献66.
67.
Klemetti R Kurinczuk JJ Redshaw M 《European journal of obstetrics, gynecology, and reproductive biology》2011,154(2):157-162
Objective
The study aims to describe older women's self-reported pregnancy-related symptoms, health and use of antenatal services by parity.Study design
The data were collected in a national survey of women who gave birth in one week in England in 2006. A random sample of 4800 participants was drawn via birth registration by the Office for National Statistics. Women were contacted at three months postpartum and a 63% response rate was achieved. Older women's (35 years or more, n = 692) experience of pregnancy-related symptoms and use of antenatal services were compared with those of younger women (<25 years n = 336 and 25-34 years, n = 1957) using logistic regression (odds ratios (ORs) and 95% confidence intervals (CI)) and adjusting for available confounding factors such as ethnicity, marital status, deprivation and education.Results
The older women had fewer antenatal visits, overnight stays in hospital, and pregnancy-related symptoms than women aged <25 years. Overall, the most common symptoms were nausea 68%, heartburn 62%, and backache 51%. Symptom prevalence varied with age and parity. Compared with women aged <25 years older women were less likely to have vomiting (adjusted OR, 95% CI: 0.49, 0.35-0.70), backache (0.42, 0.32-0.55), and to experience depression (0.58, 0.37-0.90) and more likely to have haemorrhoids (1.81, 1.31-2.47). Compared with women aged 25-34 years they were less likely to have vomiting (0.76, 0.58-0.99) but more likely to have varicose veins (1.39, 1.03-1.88), haemorrhoids (1.60, 1.31-1.96), carpal tunnel syndrome (1.34, 1.03-1.75), and stress incontinence (1.35, 1.05-1.45).Conclusion
Substantial numbers of women reported pregnancy-related symptoms likely to cause discomfort and affect daily life. Older women used antenatal health care less and experienced fewer symptoms but those reported were of the type that are more likely to persist after pregnancy, with the exception of depression, which was most commonly reported by the youngest women. 相似文献68.
69.
Fausto Biancari MD PhD Jouni Pykäri MD Mikko Savontaus MD PhD Mika Laine MD PhD Annastiina Husso MD PhD Marko Virtanen MD Pasi Maaranen MD Matti Niemelä MD PhD Timo Mäkikallio MD PhD Tuomas Tauriainen MD PhD Markku Eskola MD PhD Peter Raivio MD PhD Antti Valtola Tatu Juvonen MD PhD Juhani Airaksinen MD PhD 《Catheterization and cardiovascular interventions》2021,97(4):E560-E568