Real-world Treatment Patterns of Lung Cancer- experience of Resource Restricted Country

Abstract

Background:Lung cancer (LC) continues to be a significant worldwide public health issue. In recent years there have been several publications addressing specifics of LC worldwide, but none concerning Georgia- country with high number of smoking population and LC cases. We conducted the first study in Georgian population, that aims current LC practice.Methods: The aim of the study was to provide an overview of treatment of LC, with discussion situation in this field and indicating the future strategies for improved cancer care in the country. Medical, radiation and surgical oncologists providing treatment of LC in main hospitals (n=13) over the country, filled questionnaire that addressed specific information regarding the treatment aspects of LC reflecting current surgical aspects, systemic treatment and radiotherapy (RT). ResultsThere is no national screening program, while radiologic imaging is readily available. The vast majority of patients in the country present with advanced stages at diagnosis and they are treated with systemic therapy and/or RT. The surgical treatment is largely underutilized with the differences being observed among surgeons on the optimal timing and the extent of surgery, as well as role of surgery in specific clinical situations.Improved health care system, well equipped hospitals, availability of many anticancer drugs and existence of modern RT technology, are coupled with slow appearance of country-adapted guidelines and protocols as well as enforcing MDT meetings.There is limited access to expensive novel agents, psychological support and high quality palliative care. ConclusionsThere is still much work to be done, with all above steps considered mandatory to improve effectiveness and quality of care of LC patients.