Patients Selected for Definitive Concurrent Chemoradiation at High-volume Facilities Achieve Improved Survival in Stage III Non–Small-Cell Lung Cancer

Abstract

Our findings suggest that treatment at HVF is associated with improved overall survival among stage III NSCLC patients receiving definitive CCRT, independent of academic affiliation. Further research is needed to determine whether or not efforts supporting centralization of radiotherapy at HVF will improve population-based survival, toxicities, and costs.

Association Between Treatment at a High-Volume Facility and Improved Survival for Radiation-Treated Men With High-Risk Prostate Cancer

“…We believe this case volume effect is likely true for other disease sites besides prostate cancer, as Wang et al (12) also recently reported improved survival for patients treated at high-volume facilities in the setting of concurrent chemoradiation for stage III non-small cell lung cancer. There are multiple potential reasons underlying this effect.…”

“…This association was attributed to the hospital and surgeon's experience which yielded improved rates of achieving negative margins (6)(7)(8) and higher rates of dissecting involved lymph nodes (6,9,10). However, there is limited data about whether this volume effect exists in radiation-treated cancer patients (11), and whether treatment at a radiation facility that treats a high case volume of cancer patients is associated with improved survival (12). To explore this possibility, we conducted a nationwide cancer database analysis to specifically compare the overall survival of radiation-treated high-risk prostate cancer in high versus low radiation case volume (RCV) facilities.…”

Disparities in radiation therapy delivery: current evidence and future directions in head and neck cancer

“…An increasing amount of data supports the hypothesis that radiation therapy by high-volume providers is associated with improved outcomes in HNC [13,14] and multiple non-HNC malignancies like lung, cervical, and prostate cancers [15][16][17][18]. In HNC, two recent large national database analyses have noted disparities in access to high-volume providers, which may serve as another proxy for access to high-quality cancer care.…”

Case volume and improved outcomes across cancer care

“…1–3 Indeed, the findings by Chen et al 4 add to a growing body of evidence in other cancer types relating provider experience to improved oncological outcomes in patients treated with definitive radiation, with recent reports indicating similar relationships in patients undergoing definitive radiation for cervical cancer and definitive chemoradiation for stage III non-small-cell lung cancer. 5, 6 …”