Publication Date:
2009-11-20
Description:
Abstract 897 Background: Since the 1970s, cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) has been the standard treatment for patients with diffuse large B-cell lymphoma (DLBCL). Beginning in 2002, published randomized, controlled clinical trials changed the standard of care by demonstrating that when rituximab is added to CHOP complete response rates and overall survival improved. However, it remains unclear how these results influenced the use of combination chemo-immunotherapy in clinical practice in the United States. We examined a national cohort of patients with DLBCL to assess clinical and demographic features of patients who receive chemo-immunotherapy and those who do not. Methods: Patients diagnosed with DLBCL (ICD-O codes 9679 and 9680) between January 1, 2001 and December 31, 2004, were selected from the National Cancer DataBase (NCDB), a hospital-based cancer registry jointly sponsored by the American Cancer Society and the American College of Surgeons that includes more than 1,400 Commission-on-Cancer-approved sites and captures ∼75% of all newly diagnosed cases of cancer in the United States. Data on patient demographics, stage at diagnosis, health insurance, area-level education status, facility characteristics, and type of treatment were collected. Multivariable log binomial models were performed to examine the association between race, insurance and the use chemo-immunotherapy compared with chemotherapy alone, adjusting for other covariates. Results: The study population included 38,002 patients with DLBCL. Overall, 27% received combination chemo-immunotherapy and 50% received chemotherapy alone. At diagnosis there were racial differences in baseline characteristics. Black pts were younger (median age 53 vs. 70 years), more likely to present with stage III/IV disease (44.5% vs. 40.9%), more likely to be uninsured (9.5% vs. 2.5%) or Medicaid insured (17.3% vs. 3.4%) and more likely to reside in a zip code where ≥29% of the population had no high school diploma (38.1% vs. 11.6%) when compared with White pts (all p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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