[Treatment of anemia and bone metastasis in metastatic non-small-cell lung cancer. A French survey]

[Anemia and lung cancer]

Erythopoietin (EPO) treatment of anemia during cancer has dramatically improved the tolerance of chemotherapy and quality of life of patients at all stages of the disease. Several surveys have demonstrated a high prevalence and a high incidence of anemia in lung cancer patients. The guidelines updates concerning EPO treatment for these patients are described. They take into account the debate concerning the potential harm of these molecules on the neoplastic disease and the possible role of EPO receptors expressed by several tumors, including non small cell lung cancer.

[Evaluation of clinical practice in pulmonary oncology: a review of the literature]

INTRODUCTION

Evaluation of clinical practice in pulmonary oncology aims to improve both the quality of care and the control of costs.

REVIEW OF THE LITERATURE

A Medline search of the literature allowed analysis of the published studies of the evaluation of clinical practice. They showed that though 82-95% of patients with small cell bronchial carcinoma were treated with a combination of etoposide and cisplatin, less than half of the patients with non-small cell cancer received treatment.

VIEWPOINT

Various factors such as age, comorbidity, race, socio-economic status and gender affect the treatment decisions. There is also a discrepancy between the trial data and clinical practice that could be explained by two factors. On one hand advances are not always adopted by doctors and on the other hand the patient populations treated may sometimes be different from those in the trials.

CONCLUSION

Though the number of published studies is still low an increase is to be expected on account of the publication of new regulations concerning the evaluation of clinical practice and the appropriate use of drugs.

[An economic analysis of the management of bone metastases in lung cancer]

BACKGROUND

Bone metastases are common in lung cancer and are leading to increasing consumption of health care resources. The therapeutic choice for the clinician is extensive, from biphosphonates to percutaneous vertebroplasty. In the absence of official guidelines the management varies from centre to centre. There are very few economic analyses of these patients.

METHODS

Study 06-01 of the French Lung Oncology Group is a medico-economic analysis of the management of bone metastases in lung cancer. It is a national, multicentre, observational, epidemiological study. The primary objective is to assess the epidemiology, the management strategies and the costs of bone metastases in lung cancer. The secondary objective is to develop a medico-economic model of the management based on a Markov model in order to evaluate the effectiveness of different therapeutic strategies.

EXPECTED RESULTS

The aim of this study is a better understanding of theses patients at a time when few observational studies have been undertaken.