Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN, USA.
Canadian Cancer Trials Group, Kingston, ON, Canada.
Oncologist. 2023 Sep 7;28(9):799-803. doi: 10.1093/oncolo/oyad128.
When cancer treatments have similar oncologic outcomes, the number of days with in-person healthcare contact (""contact days'') can help contextualize expected time use with each treatment. We assessed contact days in a completed randomized clinical trial.
We conducted a secondary analysis of the CCTG LY.12 RCT that evaluated 2-3 cycles of gemcitabine, dexamethasone, and cisplatin (GDP) vs. dexamethasone, cytarabine, and cisplatin (DHAP) in 619 patients with relapsed/refractory lymphoma prior to stem cell transplant. Primary analyses reported similar response rates and survival. We calculated patient-level "contact days" by analyzing trial forms. The study period was from assignment to progression or transplant. Days without healthcare contact were considered "home days''. We compared measures of contact days across arms.
The study period was longer in the GDP arm (median 50, vs. 47 days, P = .007). Contact days were comparable in both arms (median 18 vs 19, P = 0.79), but home days were higher in the GDP arm (median 33 vs 28, P < .001). The proportion of contact days was lower in the GDP arm (34%, vs. 38%, P = .009). The GDP arm experienced more contact days related to planned outpatient chemotherapy (median, 10 vs. 8 days), but the DHAP arm experienced many more inpatient contact days (median, 11 vs. 0 days).
Measures of time use, such as contact days, can be extracted from RCTs. In LY.12, despite comparable oncologic outcomes, GDP was associated with fewer contact days. Such information can guide decision-making for patients with hematological cancers, who already face significant healthcare contact.
当癌症治疗的肿瘤学结果相似时，与治疗相关的实际医疗接触天数（“接触天数”）可以帮助了解每种治疗方法的预期时间。我们评估了一项已完成的随机临床试验中的接触天数。
我们对 CCTG LY.12 RCT 进行了二次分析，该试验评估了 619 例复发/难治性淋巴瘤患者在干细胞移植前接受 2-3 周期吉西他滨、地塞米松和顺铂（GDP）与地塞米松、阿糖胞苷和顺铂（DHAP）的情况。主要分析报告了相似的缓解率和生存率。我们通过分析试验表格计算了患者水平的“接触天数”。研究期间从分配到进展或移植。没有医疗接触的天数被认为是“在家天数”。我们比较了不同手臂的接触天数。
GDP 组的研究期较长（中位数 50 天 vs. 47 天，P=0.007）。两个治疗组的接触天数相似（中位数 18 天 vs. 19 天，P=0.79），但 GDP 组的在家天数更高（中位数 33 天 vs. 28 天，P<0.001）。GDP 组的接触天数比例较低（34% vs. 38%，P=0.009）。GDP 组与计划门诊化疗相关的接触天数较多（中位数 10 天 vs. 8 天），而 DHAP 组的住院接触天数更多（中位数 11 天 vs. 0 天）。
从 RCT 中可以提取出时间使用等措施，例如接触天数。在 LY.12 中，尽管肿瘤学结果相似，但 GDP 与接触天数较少相关。这些信息可以为患有血液系统癌症的患者提供决策指导，他们已经面临大量的医疗接触。
