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\footnotesize
\noindent Statistica Sinica {\bf 17}(2007), 445-462

\vspace{3pc} \normalsize
\centerline{\large\bf BAYESIAN APPROACHES TO JOINT LONGITUDINAL}
\vspace{2pt}
\centerline{\large\bf  AND SURVIVAL MODELS ACCOMMODATING BOTH}
\vspace{2pt}
\centerline{\large\bf  ZERO AND NONZERO CURE FRACTIONS}
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\author{Yueh-Yun Chi and Joseph G. Ibrahim}
\vspace{.4cm} \centerline{\it University of Washington and
University of North Carolina at Chapel Hill} \vspace{.55cm}
\begin{quotation}
\noindent {\it Abstract:} The trade-offs between survival benefits
and therapeutic adverse effects on quality of life (QOL) is always
an important clinical issue for cancer and AIDS patients. The
International Breast Cancer Study Group (IBCSG) conducted a large
clinical trial, IBCSG Trial VI, to examine the duration and timing
of adjuvant therapy for advanced breast cancer patients after the
initial removal surgery. We present a novel joint model for
longitudinal and survival data to evaluate the relationship between
QOL and breast cancer progression, and also assess issues associated
with different therapeutic procedures and baseline covariates.
Multidimensional longitudinal QOL measurements are modeled in a
hierarchical mixed effects model to account for psychological
fluctuations and measurement errors, provide estimates for time
points where QOL data are not available, and to explicitly allow for
direct inferences about different dependence structures in the QOL
data over time and over different QOL measures (indicators). A
parametric survival model is also proposed for disease-free survival
(DFS) to incorporate the underlying smooth QOL trajectories and
prognostic factors. This survival model is attractive and capable of
accommodating {\em both} zero and nonzero cure fractions. With
advances in modern medicine, a positive cure fraction is often
tenable for breast cancer patients since many are completely cured
after surgery, and are no longer susceptible to relapse. A Bayesian
paradigm is adopted to facilitate the estimation process and ease
the computational complexity.
\par
\vspace{9pt}
\noindent {\it Key words and phrases:}
Breast cancer clinical trial, Cure rate
model, random effects.\par
\end{quotation}

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