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Patient- and Tumor-Level Factors Impacting Chemotherapy Use and Effectiveness- [electronic resource]
Patient- and Tumor-Level Factors Impacting Chemotherapy Use and Effectiveness- [electronic resource]
상세정보
- 자료유형
- 학위논문파일 국외
- 최종처리일시
- 20240214101238
- ISBN
- 9798380135672
- DDC
- 614.4
- 서명/저자
- Patient- and Tumor-Level Factors Impacting Chemotherapy Use and Effectiveness - [electronic resource]
- 발행사항
- [S.l.]: : The University of North Carolina at Chapel Hill., 2023
- 발행사항
- Ann Arbor : : ProQuest Dissertations & Theses,, 2023
- 형태사항
- 1 online resource(137 p.)
- 주기사항
- Source: Dissertations Abstracts International, Volume: 85-02, Section: B.
- 주기사항
- Advisor: Troester, Melissa.
- 학위논문주기
- Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2023.
- 사용제한주기
- This item must not be sold to any third party vendors.
- 초록/해제
- 요약Background: Chemotherapy efficacy is determined in clinical trial settings, which have limited representation of Black women. In clinical practice, there is more variation in how chemotherapy regimens are assigned and whether they are completed. Identifying factors related to chemotherapy receipt and cessation, as well as factors across which chemotherapy effectiveness may vary, may help to improve clinical outcomes among breast cancer patients.Methods: This project had three primary goals: 1) to describe real-world patterns of chemotherapy receipt and regimens in a diverse population of women with incident breast cancer, 2) to identify factors associated with cessation of chemotherapy, and 3) to explore the relationship between tumor biological characteristics and recurrence within chemotherapy treatment groups.Results: In Aim 1, both clinical characteristics and younger age at diagnosis were strongly associated with receipt of any chemotherapy and with receipt of anthracycline-inclusive regimens. There was not strong evidence of a relationship between race and receipt of chemotherapy. Next, an association was observed between both adjuvant and neoadjuvant chemotherapy regimens and early cessation of chemotherapy. There was also evidence that side effects were strongly associated with cessation of adjuvant chemotherapy. Within patient- and tumor-level characteristics, associations between these factors and cessation varied by chemotherapy regimen. Cessation of chemotherapy was associated with more breast cancer recurrence after treatment. In Aim 2, chemotherapy regimens were associated with recurrence. In unadjusted models, taxane-based treatment was associated with lower recurrence; however, after adjustment for features of disease aggressiveness, this relationship shifted and taxane-based treatment was associated with increased recurrence. Biological factors associated with DNA damage repair (p53, homologous recombination deficiency) were predictive of recurrence among women receiving anthracycline-inclusive regimens, but not among women receiving taxane-based regimens. The prognostic value of Ki-67 status did not vary by chemotherapy regimen.Conclusions: Chemotherapy receipt and cessation vary by some demographic characteristics. Effectiveness of chemotherapy may vary by adherence to treatment and by biological characteristics of the tumor.
- 일반주제명
- Epidemiology.
- 일반주제명
- Oncology.
- 일반주제명
- Clinical psychology.
- 키워드
- Cessation
- 키워드
- Chemotherapy
- 기타저자
- The University of North Carolina at Chapel Hill Epidemiology
- 기본자료저록
- Dissertations Abstracts International. 85-02B.
- 기본자료저록
- Dissertation Abstract International
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
008240612s2023 us |||||||||||||||c||eng d■001000016933368
■00520240214101238
■006m o d
■007cr#unu||||||||
■020 ▼a9798380135672
■035 ▼a(MiAaPQ)AAI30528100
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a614.4
■1001 ▼aOlsson, Linnea Teresa.
■24510▼aPatient- and Tumor-Level Factors Impacting Chemotherapy Use and Effectiveness▼h[electronic resource]
■260 ▼a[S.l.]:▼bThe University of North Carolina at Chapel Hill. ▼c2023
■260 1▼aAnn Arbor :▼bProQuest Dissertations & Theses, ▼c2023
■300 ▼a1 online resource(137 p.)
■500 ▼aSource: Dissertations Abstracts International, Volume: 85-02, Section: B.
■500 ▼aAdvisor: Troester, Melissa.
■5021 ▼aThesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2023.
■506 ▼aThis item must not be sold to any third party vendors.
■520 ▼aBackground: Chemotherapy efficacy is determined in clinical trial settings, which have limited representation of Black women. In clinical practice, there is more variation in how chemotherapy regimens are assigned and whether they are completed. Identifying factors related to chemotherapy receipt and cessation, as well as factors across which chemotherapy effectiveness may vary, may help to improve clinical outcomes among breast cancer patients.Methods: This project had three primary goals: 1) to describe real-world patterns of chemotherapy receipt and regimens in a diverse population of women with incident breast cancer, 2) to identify factors associated with cessation of chemotherapy, and 3) to explore the relationship between tumor biological characteristics and recurrence within chemotherapy treatment groups.Results: In Aim 1, both clinical characteristics and younger age at diagnosis were strongly associated with receipt of any chemotherapy and with receipt of anthracycline-inclusive regimens. There was not strong evidence of a relationship between race and receipt of chemotherapy. Next, an association was observed between both adjuvant and neoadjuvant chemotherapy regimens and early cessation of chemotherapy. There was also evidence that side effects were strongly associated with cessation of adjuvant chemotherapy. Within patient- and tumor-level characteristics, associations between these factors and cessation varied by chemotherapy regimen. Cessation of chemotherapy was associated with more breast cancer recurrence after treatment. In Aim 2, chemotherapy regimens were associated with recurrence. In unadjusted models, taxane-based treatment was associated with lower recurrence; however, after adjustment for features of disease aggressiveness, this relationship shifted and taxane-based treatment was associated with increased recurrence. Biological factors associated with DNA damage repair (p53, homologous recombination deficiency) were predictive of recurrence among women receiving anthracycline-inclusive regimens, but not among women receiving taxane-based regimens. The prognostic value of Ki-67 status did not vary by chemotherapy regimen.Conclusions: Chemotherapy receipt and cessation vary by some demographic characteristics. Effectiveness of chemotherapy may vary by adherence to treatment and by biological characteristics of the tumor.
■590 ▼aSchool code: 0153.
■650 4▼aEpidemiology.
■650 4▼aOncology.
■650 4▼aClinical psychology.
■653 ▼aAdjuvant chemotherapy
■653 ▼aCessation
■653 ▼aChemotherapy
■653 ▼aNeoadjuvant chemotherapy
■690 ▼a0766
■690 ▼a0992
■690 ▼a0622
■71020▼aThe University of North Carolina at Chapel Hill▼bEpidemiology.
■7730 ▼tDissertations Abstracts International▼g85-02B.
■773 ▼tDissertation Abstract International
■790 ▼a0153
■791 ▼aPh.D.
■792 ▼a2023
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T16933368▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
■980 ▼a202402▼f2024
