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Development of a Model to Estimate the Association Between Delay in Cancer Treatment and Local Tumor Control and Risk of Metastases.
Ng, John; Stovezky, Yael R; Brenner, David J; Formenti, Silvia C; Shuryak, Igor.
  • Ng J; Department of Radiation Oncology, Weill Cornell Medicine, New York, New York.
  • Stovezky YR; Weill Cornell Medical College, New York, New York.
  • Brenner DJ; Center for Radiological Research, Columbia University Irving Medical Center, New York, New York.
  • Formenti SC; Department of Radiation Oncology, Weill Cornell Medicine, New York, New York.
  • Shuryak I; Center for Radiological Research, Columbia University Irving Medical Center, New York, New York.
JAMA Netw Open ; 4(1): e2034065, 2021 01 04.
Article in English | MEDLINE | ID: covidwho-1049541
Semantic information from SemMedBD (by NLM)
1. Malignant Neoplasms PROCESS_OF Patients
Subject
Malignant Neoplasms
Predicate
PROCESS_OF
Object
Patients
2. COVID-19 AFFECTS Patients
Subject
COVID-19
Predicate
AFFECTS
Object
Patients
3. Delayed Treatment PREDISPOSES Neoplasm Metastasis
Subject
Delayed Treatment
Predicate
PREDISPOSES
Object
Neoplasm Metastasis
4. tumor growth AFFECTS Neoplasms
Subject
tumor growth
Predicate
AFFECTS
Object
Neoplasms
5. Head and Neck Neoplasms AFFECTS Neoplasms
Subject
Head and Neck Neoplasms
Predicate
AFFECTS
Object
Neoplasms
6. Head and Neck Neoplasms COEXISTS_WITH Neoplasm Metastasis
Subject
Head and Neck Neoplasms
Predicate
COEXISTS_WITH
Object
Neoplasm Metastasis
7. SPRR2A protei AFFECTS C0027651
Subject
SPRR2A protei
Predicate
AFFECTS
Object
C0027651
8. Colorectal Neoplasms COEXISTS_WITH Neoplasm Metastasis
Subject
Colorectal Neoplasms
Predicate
COEXISTS_WITH
Object
Neoplasm Metastasis
9. GPR162 gene|GPR162 AFFECTS Neoplasms
Subject
GPR162 gene|GPR162
Predicate
AFFECTS
Object
Neoplasms
10. Lung Neoplasms COEXISTS_WITH Neoplasm Metastasis
Subject
Lung Neoplasms
Predicate
COEXISTS_WITH
Object
Neoplasm Metastasis
11. Malignant Neoplasms PROCESS_OF Patients
Subject
Malignant Neoplasms
Predicate
PROCESS_OF
Object
Patients
12. COVID-19 AFFECTS Patients
Subject
COVID-19
Predicate
AFFECTS
Object
Patients
13. Delayed Treatment PREDISPOSES Neoplasm Metastasis
Subject
Delayed Treatment
Predicate
PREDISPOSES
Object
Neoplasm Metastasis
14. tumor growth AFFECTS Neoplasms
Subject
tumor growth
Predicate
AFFECTS
Object
Neoplasms
15. Head and Neck Neoplasms AFFECTS Neoplasms
Subject
Head and Neck Neoplasms
Predicate
AFFECTS
Object
Neoplasms
16. Head and Neck Neoplasms COEXISTS_WITH Neoplasm Metastasis
Subject
Head and Neck Neoplasms
Predicate
COEXISTS_WITH
Object
Neoplasm Metastasis
17. SPRR2A protein, human|SPRR2A AFFECTS Neoplasms
Subject
SPRR2A protein, human|SPRR2A
Predicate
AFFECTS
Object
Neoplasms
18. Colorectal Neoplasms COEXISTS_WITH Neoplasm Metastasis
Subject
Colorectal Neoplasms
Predicate
COEXISTS_WITH
Object
Neoplasm Metastasis
19. GPR162 gene|GPR162 AFFECTS Neoplasms
Subject
GPR162 gene|GPR162
Predicate
AFFECTS
Object
Neoplasms
20. Lung Neoplasms COEXISTS_WITH Neoplasm Metastasis
Subject
Lung Neoplasms
Predicate
COEXISTS_WITH
Object
Neoplasm Metastasis
ABSTRACT
Importance The coronavirus disease 2019 (COVID-19) pandemic has led to treatment delays for many patients with cancer. While published guidelines provide suggestions on which cases are appropriate for treatment delay, there are no good quantitative estimates on the association of delays with tumor control or risk of new metastases.

Objectives:

To develop a simplified mathematical model of tumor growth, control, and new metastases for cancers with varying doubling times and metastatic potential and to estimate tumor control probability (TCP) and metastases risk as a function of treatment delay interval. Design, Setting, and

Participants:

This decision analytical model describes a quantitative model for 3 tumors (ie, head and neck, colorectal, and non-small cell lung cancers). Using accepted ranges of tumor doubling times and metastatic development from the clinical literature from 2001 to 2020, estimates of tumor growth, TCP, and new metastases were analyzed for various treatment delay intervals. Main Outcomes and

Measures:

Risk estimates for potential decreases in local TCP and increases in new metastases with each interval of treatment delay.

Results:

For fast-growing head and neck tumors with a 2-month treatment delay, there was an estimated 4.8% (95% CI, 3.4%-6.4%) increase in local tumor control risk and a 0.49% (0.47%-0.51%) increase in new distal metastases risk. A 6-month delay was associated with an estimated 21.3% (13.4-30.4) increase in local tumor control risk and a 6.0% (5.2-6.8) increase in distal metastases risk. For intermediate-growing colorectal tumors, there was a 2.1% (0.7%-3.5%) increase in local tumor control risk and a 2.7% (2.6%-2.8%) increase in distal metastases risk at 2 months and a 7.6% (2.2%-14.2%) increase in local tumor control risk and a 24.7% (21.9%-27.8%) increase in distal metastases risk at 6 months. For slower-growing lung tumors, there was a 1.2% (0.0%-2.8%) increase in local tumor control risk and a 0.19% (0.18%-0.20%) increase in distal metastases risk at 2 months, and a 4.3% (0.0%-10.6%) increase in local tumor control risk and a 1.9% (1.6%-2.2%) increase in distal metastases risk at 6 months. Conclusions and Relevance This study proposed a model to quantify the association of treatment delays with local tumor control and risk of new metastases. The detrimental associations were greatest for tumors with faster rates of proliferation and metastasis. The associations were smaller, but still substantial, for slower-growing tumors.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Decision Support Techniques / Time-to-Treatment / Models, Theoretical / Neoplasm Metastasis / Neoplasms Type of study: Diagnostic study / Observational study / Prognostic study Limits: Humans Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Decision Support Techniques / Time-to-Treatment / Models, Theoretical / Neoplasm Metastasis / Neoplasms Type of study: Diagnostic study / Observational study / Prognostic study Limits: Humans Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article