Use of Adjuvant Chemotherapy in Non-small Cell Lung Cancer in Routine Practice

Massard, Christophe; Loc, Pierre Tran Ba; Haddad, Vincent; Pignon, Jean-Pierre; Girard, Philippe; Monnet, I.; Trédaniel, Jean; Besse, Benjamin; Soria, Jean‐Charles

doi:10.1097/jto.0b013e3181bbf1c9

Cited by 15 publications

(12 citation statements)

References 32 publications

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“…20 Other studies of AC uptake after 2004 reported use rates of approximately 40% among eligible patients at single facilities. 21,22 When evaluating the effect of AC on outcome over time, it is important to evaluate possible changes in diagnosis, staging, and treatment patterns. We considered, but did not observe, variation in surgical treatment patterns and evidence of a stage shift between 2001 and 2008 that would significantly influence survival outcomes.…”

Section: Discussionmentioning

confidence: 99%

Use and impact of adjuvant chemotherapy in patients with resected non‐small cell lung cancer

Williams

Gajra

Ganti

et al. 2014

Cancer

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BACKGROUND Despite clinical trials demonstrating improved survival with adjuvant chemotherapy (AC) for patients with American Joint Committee on Cancer stages I to III non‐small cell lung cancer (NSCLC), it is unclear whether this survival benefit extends to broader populations. The current study evaluated patterns of AC use and examined the impact of AC on survival. METHODS A retrospective analysis was conducted of patients in the Veterans Affairs Central Cancer Registry diagnosed with stages IB to IIIA NSCLC between 2001 and 2008. Descriptive statistics were used to examine patterns of AC use over an 8‐year time period. Cox proportional hazards regression analyses were used to estimate hazards ratios (HR) and 95% confidence intervals (95% CIs) to compare mortality risk among patients treated with and without AC. RESULTS Among 14,306 patients with stages IB to IIIA NSCLC, 4929 underwent surgery and 22% of these received AC. The percentages of patients diagnosed in 2001 through 2003, 2004 through 2005, and 2006 through 2008 receiving AC were 7.0%, 29.8%, and 29.5%, respectively. There was no survival benefit with AC noted for patients diagnosed between 2001 and 2003, but AC was associated with improved survival for the period between 2004 and 2005 (HR, 0.78; 95% CI, 0.67‐0.91) and 2006 through 2008 (HR, 0.79; 95% CI, 0.69‐0.91). Of those patients receiving AC, 89% received platinum‐doublet chemotherapy. Carboplatin remained the most common agent, although cisplatin use reached 43% in the period between 2006 and 2008. The HR for cisplatin relative to carboplatin was 0.96 (95% CI, 0.80‐1.15). CONCLUSIONS There was a significant increase in the use of AC between 2001 and 2008 and AC was associated with an improvement in overall survival. Cancer 2014;120:1939–1947. © 2014 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Use and impact of adjuvant chemotherapy in patients with resected non‐small cell lung cancer

Williams

Gajra

Ganti

et al. 2014

Cancer

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“…The relatively lower uptake of chemotherapy in our study could be a result of the proportion (about 70%) of patients with stage i disease in our population-based cohort, which is large compared with that in populations from individual tertiary-care centres that primarily see patients at more advanced disease stages. Massard et al 28 and Kassam et al 29 reported overall chemotherapy uptake rates of 40% and 46% for patient cohorts involving 53% and 67% stage i disease respectively.…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy Uptake and Wait Times in Early-Stage Non-Small-Cell Lung Cancer

Gray

Saint-Jacques

et al. 2012

Current Oncology

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“…A study by Winget et al 28 that included 561 patients with stage ib and ii nsclc diagnosed in Alberta during [2004][2005][2006] found that advanced age and rural residence were inversely associated with the likelihood of attendance at a consultation with a medical oncologist. Among the 226 patients who saw a medical oncologist, act was not recommended in 25% of cases, and it was refused by 31 . Age, stage, and comorbidity were found to influence patterns of treatment.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Referral to Medical Oncology and Subsequent Use of Adjuvant Chemotherapy for Non-Small-Cell Lung Cancer: A Population-Based Study

et al. 2013

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stage ii or iii than with stage i disease (ors: 3.0, 2.7 respectively; p < 0.001); use also varied with geographic location (range: 46%-63%). ConclusionsThe initial decision to refer to medical oncology is associated with age and stage of disease, and those factors have an even greater effect on the decision to offer act. Comorbidity and postoperative length of stay were not associated with initial referral, but were associated with use of act in patients seen by medical oncology.

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Use of Adjuvant Chemotherapy in Non-small Cell Lung Cancer in Routine Practice

Cited by 15 publications

References 32 publications

Use and impact of adjuvant chemotherapy in patients with resected non‐small cell lung cancer

Use and impact of adjuvant chemotherapy in patients with resected non‐small cell lung cancer

Chemotherapy Uptake and Wait Times in Early-Stage Non-Small-Cell Lung Cancer

Factors Associated with Referral to Medical Oncology and Subsequent Use of Adjuvant Chemotherapy for Non-Small-Cell Lung Cancer: A Population-Based Study

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