How is advanced melanoma treated in the Public Health System in Brazil: a call for change.
Introduction: Treatment of advanced melanoma has been revolutionized in the last decade. The adoption of new treatments is necessary in order to offer significantly longer survival. Objective: To evaluate how patients are being treated for advanced melanoma at the Public Health System in...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Oncologia Clínica, Sociedade Brasileira de Cirurgia Clínica and Sociedade Brasileira de Radioterapia
2019-01-01
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| Series: | Brazilian Journal of Oncology |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.5935/2526-8732.20190020 |
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| author | Rafael Aliosha Kaliks Andre Marques Santos Tiago Farina Matos Luciana Holtz |
| author_facet | Rafael Aliosha Kaliks Andre Marques Santos Tiago Farina Matos Luciana Holtz |
| author_sort | Rafael Aliosha Kaliks |
| collection | DOAJ |
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Introduction: Treatment of advanced melanoma has been revolutionized in the last decade. The adoption of new treatments is necessary in order to offer significantly longer survival. Objective: To evaluate how patients are being treated for advanced melanoma at the Public Health System in Brazil. Methods: We evaluated the Authorization of Ambulatory Care Procedure (APAC) related to all patients treated for advanced melanoma between January 2015 and December 2017. We grouped treatments according to their reported efficacy as being inadequate, minimally effective, moderately effective or effective treatments. We evaluated treatments given according to the efficacy, variety of treatments in first line and duration of overall treatment. Results: We analyzed 10,843 APACs, related to the treatment of 4,338 patients. Patients were 57% male, 43% female, 72% were older than 50 years of age. The median number of APACs filled per patient was 2 (ranging from 1 to 15). The mean of different types of treatment prescribed to individual patients was 1.22 (1 - 5). We identified 19 different treatment protocols used as first line, of which 11 consisted of single drug and 8 of drug combinations. Over the two-year period, 3,097 (88%) and 281 (8%) patients initiated treatment with a minimally effective or moderately effective regimen, respectively. Only 0.4% of patients initiated their treatment with an effective therapy. The average length on any treatment was six months. Conclusion: More than 98% of patients treated between 2015 and 2017 for advanced melanoma at the Public Health System in Brazil received minimally effective treatments. |
| format | Article |
| id | doaj-art-040dfde987834692a5bb0c9a61d360a2 |
| institution | Kabale University |
| issn | 2526-8732 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Sociedade Brasileira de Oncologia Clínica, Sociedade Brasileira de Cirurgia Clínica and Sociedade Brasileira de Radioterapia |
| record_format | Article |
| series | Brazilian Journal of Oncology |
| spelling | doaj-art-040dfde987834692a5bb0c9a61d360a22024-11-29T10:30:40ZengSociedade Brasileira de Oncologia Clínica, Sociedade Brasileira de Cirurgia Clínica and Sociedade Brasileira de RadioterapiaBrazilian Journal of Oncology2526-87322019-01-011510.5935/2526-8732.20190020How is advanced melanoma treated in the Public Health System in Brazil: a call for change.Rafael Aliosha Kaliks0https://orcid.org/0000-0003-4728-535XAndre Marques Santos1Tiago Farina Matos2Luciana Holtz3Hospital Israelita Albert Einstein, Medical OncologyCliqueSUS, Scientific - São Paulo - SP - BrazilInstituto Oncoguia, Institute - São Paulo - SP - BrazilInstituto Oncoguia, Institute - São Paulo - SP - Brazil Introduction: Treatment of advanced melanoma has been revolutionized in the last decade. The adoption of new treatments is necessary in order to offer significantly longer survival. Objective: To evaluate how patients are being treated for advanced melanoma at the Public Health System in Brazil. Methods: We evaluated the Authorization of Ambulatory Care Procedure (APAC) related to all patients treated for advanced melanoma between January 2015 and December 2017. We grouped treatments according to their reported efficacy as being inadequate, minimally effective, moderately effective or effective treatments. We evaluated treatments given according to the efficacy, variety of treatments in first line and duration of overall treatment. Results: We analyzed 10,843 APACs, related to the treatment of 4,338 patients. Patients were 57% male, 43% female, 72% were older than 50 years of age. The median number of APACs filled per patient was 2 (ranging from 1 to 15). The mean of different types of treatment prescribed to individual patients was 1.22 (1 - 5). We identified 19 different treatment protocols used as first line, of which 11 consisted of single drug and 8 of drug combinations. Over the two-year period, 3,097 (88%) and 281 (8%) patients initiated treatment with a minimally effective or moderately effective regimen, respectively. Only 0.4% of patients initiated their treatment with an effective therapy. The average length on any treatment was six months. Conclusion: More than 98% of patients treated between 2015 and 2017 for advanced melanoma at the Public Health System in Brazil received minimally effective treatments.http://www.thieme-connect.de/DOI/DOI?10.5935/2526-8732.20190020MelanomaCombined modality therapyHealth systemsUnified health systemNeoplasm metastasis.MelanomaTerapia de modalidade combinadaSistemas de saúdeSistema único de saúdeMetástase neoplásica. |
| spellingShingle | Rafael Aliosha Kaliks Andre Marques Santos Tiago Farina Matos Luciana Holtz How is advanced melanoma treated in the Public Health System in Brazil: a call for change. Brazilian Journal of Oncology Melanoma Combined modality therapy Health systems Unified health system Neoplasm metastasis. Melanoma Terapia de modalidade combinada Sistemas de saúde Sistema único de saúde Metástase neoplásica. |
| title | How is advanced melanoma treated in the Public Health System in Brazil: a call for change. |
| title_full | How is advanced melanoma treated in the Public Health System in Brazil: a call for change. |
| title_fullStr | How is advanced melanoma treated in the Public Health System in Brazil: a call for change. |
| title_full_unstemmed | How is advanced melanoma treated in the Public Health System in Brazil: a call for change. |
| title_short | How is advanced melanoma treated in the Public Health System in Brazil: a call for change. |
| title_sort | how is advanced melanoma treated in the public health system in brazil a call for change |
| topic | Melanoma Combined modality therapy Health systems Unified health system Neoplasm metastasis. Melanoma Terapia de modalidade combinada Sistemas de saúde Sistema único de saúde Metástase neoplásica. |
| url | http://www.thieme-connect.de/DOI/DOI?10.5935/2526-8732.20190020 |
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