Variations in the management and outcome of non-small cell lung cancer in Ontario

Mackillop, William J.; Dixon, Peter; Zhou, Yunzheng; Ago, C.T.; Ege, Güneş N.; Hodson, D. Ian; Kotalik, Jaro; Lochrin, C.; Paszat, Lawrence; Harris, Diana

doi:10.1016/0167-8140(94)90096-5

Cited by 49 publications

(24 citation statements)

References 22 publications

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“…In Ontario for the period between 1982 and 1991, 62% of all NSCLC patients received radiotherapy within 2 months of diagnosis, and 70% of this was to the chest. 22 Only 28% were prescribed doses greater than 40 Gy. It is difficult to find reported data of radiotherapy utilization by lung cancer stage.…”

Section: Discussionmentioning

confidence: 99%

Actual versus optimal utilization of radiotherapy in lung cancer: Where is the shortfall?

Vinod

Bartoň

2007

Asia-Pac J Clncl Oncology

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Background: Estimates of ideal radiotherapy utilization in lung cancer range from 61% to 74%. Actual utilization rates are lower than this. The aim of the present study was to identify those groups where there was the greatest discrepancy between actual and ideal utilization. Methods: The study population consisted of South-Western Sydney Area Health Service residents who were diagnosed with lung cancer in 1993 or 1996. A clinical audit of medical records was performed to collect details on patient demographics, tumor factors, treatment details and outcome. Results: There were 527 patients diagnosed with lung cancer. Treatment data were available for 499 (95%) patients of which 279 (56%) received radiotherapy. Radiotherapy utilization declined with increasing age and decreasing performance status. When comparing actual with ideal utilization, the greatest shortfall in radiotherapy was seen in small cell lung cancer (55% vs 79%) followed by stage I (35% vs 50%) and IV non-small cell lung cancer (65% vs 83%). There was under-utilization of chest radiotherapy (79% vs 88%) and definitive radiotherapy (14% vs 50%). Conclusions: Definitive chest radiotherapy is underutilized in lung cancer, particularly in patients with limited stage small cell lung cancer and stage I non-small cell lung cancer. This is partly due to non-referral of patients but also a palliative approach by radiation oncologists. These factors have to be addressed in order to optimize survival and quality of life for lung cancer patients.

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Section: Discussionmentioning

confidence: 99%

Actual versus optimal utilization of radiotherapy in lung cancer: Where is the shortfall?

Vinod

Bartoň

2007

Asia-Pac J Clncl Oncology

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“…The need for POCS in lung cancer is driven by the variability in patterns of practice as well as the poor outcome and survival associated with it. POCS in lung cancer have been conducted in the United Kingdom (UK), 6,7 Italy, 8 Canada, 9 and the US. 10,11 In Australia, patterns of care in lung cancer have been documented in NSW (SWSAHS), 12 Victoria, 13 and South Australia.…”

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confidence: 99%

Socio‐economic status and patterns of care in lung cancer

Hui

Vinod

Jalaludin

et al. 2005

Australian and New Zealand Journal of Public Health

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“…The few studies that addressed VMP in the context of RT reported variations in medical practice and the underutilization of RT for LC [10, 11, 14, 34]. The initial articles by J E Wennberg on VMP [12, 13] systematized the possible causes of differences as follows:

Demand: clinical stage, histology, incidence, age, delay and distance from the hospital… couldn‘t explain this variability according to our results.

…”

Section: Discussionmentioning

confidence: 61%

“…There is increasing evidence that unexplained variations in practice are widespread in oncology in general. However, the problem is not confined to oncology; it should be taken into account that RT programs maintain unusually good records, and the excellence of the information systems makes variations in practice highly visible [10]. …”

Section: Discussionmentioning

confidence: 99%

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Pattern of use of radiotherapy for lung cancer: a descriptive study

Tovar

Expósito

Jaen³

et al. 2014

BMC Cancer

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BackgroundLung cancer remains one of the most prevalent forms of cancer. Radiotherapy, with or without other therapeutic modalities, is an effective treatment. Our objective was to report on the use of radiotherapy for lung cancer, its variability in our region, and to compare our results with the previous study done in 2004 (VARA-I) in our region and with other published data.MethodsWe reviewed the clinical records and radiotherapy treatment sheets of all patients undergoing radiotherapy for lung cancer during 2007 in the 12 public hospitals in Andalusia, an autonomous region of Spain. Data were gathered on hospital, patient type and histological type, radiotherapy treatment characteristics, and tumor stage.Results610 patients underwent initial radiotherapy. 37% of cases had stage III squamous cell lung cancer and were treated with radical therapy. 81% of patients with non-small and small cell lung cancer were treated with concomitant chemo-radiotherapy and the administered total dose was ≥ 60 Gy and ≥ 45 Gy respectively. The most common regimen for patients treated with palliative intent (44.6%) was 30 Gy. The total irradiation rate was 19.6% with significant differences among provinces (range, 8.5-25.6%; p < 0.001). These differences were significantly correlated with the geographical distribution of radiation oncologists (r = 0.78; p = 0.02). Our results were similar to other published data and previous study VARA-I.ConclusionsOur results shows no differences according to the other published data and data gathered in the study VARA-I. There is still wide variability in the application of radiotherapy for lung cancer in our setting that significantly correlates with the geographical distribution of radiation oncologists.

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Variations in the management and outcome of non-small cell lung cancer in Ontario

Cited by 49 publications

References 22 publications

Actual versus optimal utilization of radiotherapy in lung cancer: Where is the shortfall?

Actual versus optimal utilization of radiotherapy in lung cancer: Where is the shortfall?

Socio‐economic status and patterns of care in lung cancer

Pattern of use of radiotherapy for lung cancer: a descriptive study

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