Abstract
In Chapter 13, we discussed general concepts in the field of cancer epidemiology, and in particular, methods to estimate effects of exposures on outcomes. Various types of models were introduced and discussed, especially logistic and logit-type models of tumor control and normal tissue complication probability. These concepts have broad applications across the fi eld of oncology, particularly for assessing dose–response effects of exposures on organs and tumors. Such models are critical for designing optimal therapeutic approaches and estimating the impact of new interventions. In this chapter, we consider the problem of adverse effects on long-term morbidity and toxicity. This is particularly apropos in the setting caused by unwanted radiation dose delivery to the heart. This is of particular concern in breast cancer, because many patients survive their cancer but are subject to potentially serious late effects of therapy. This scenario is common in what is known as the survivorship setting, which affects more than 10 million people annually in the United States living with the aftereffects of cancer treatment (1). Investigation of radiation heart dose also sheds light on the importance of recognizing that exposures are often not “all or nothing, ” the importance of accurate and precise measurement of the exposure, the importance of considering comorbid illness and competing events, and the pitfalls of investigating a treatment that is evolving faster than long-term evidence can be generated.
| Original language | American English |
|---|---|
| Title of host publication | Principles of Clinical Cancer Research |
| Publisher | Springer International Publishing |
| Pages | 254-263 |
| Number of pages | 10 |
| ISBN (Electronic) | 9781617052392 |
| ISBN (Print) | 9781620700693 |
| State | Published - Nov 28 2018 |
ASJC Scopus subject areas
- General Medicine