Radiation therapy at the end of life in patients with incurable nonsmall cell lung cancer

Cancer - Tập 118 Số 17 - Trang 4339-4345 - 2012
Nirav S. Kapadia1, Rizvan Mamet2, Carrie Zornosa3, Joyce C. Niland2, Thomas A. D’Amico4, James A. Hayman5
1Department of Radiation Oncology, University of Michigan Hospital, Ann Arbor, Michigan, USA
2City of Hope Comprehensive Cancer Center, Duarte, California
3National Comprehensive Cancer Network, Fort Washington, Pennsylvania
4Duke Cancer Institute, Durham, North Carolina
5Department of Radiation Oncology, University of Michigan Hospital, Ann Arbor, Michigan

Tóm tắt

AbstractBACKGROUND:Receipt of chemotherapy at the end of life (EOL) is considered an indicator of poor quality of care for medical oncology. The objective of this study was to characterize the use of radiotherapy (RT) in patients with nonsmall cell lung cancer (NSCLC) during the same period.METHODS:Treatment characteristics of patients with incurable NSCLC who received RT at the EOL, defined as within 14 days of death, were analyzed from the National Comprehensive Cancer Network NSCLC Outcomes Database.RESULTS:Among 1098 patients who died, 10% had received EOL RT. Patients who did and did not receive EOL RT were similar in terms of sex, race, comorbid disease, and Eastern Cooperative Oncology Group performance status. On multivariable logistic regression analysis, independent predictors of receiving EOL RT included stage IV disease (odds ratio [OR], 2.04; 95% confidence interval [CI], 1.09‐3.83) or multiorgan involvement (OR, 1.75; 95% CI, 1.08‐2.84) at diagnosis, age <65 years at diagnosis (OR, 1.85; 95% CI, 1.21‐2.83), and treating institution (OR, 1.24‐5.94; P = .02). Nearly 50% of EOL RT recipients did not complete it, most commonly because of death or patient preference.CONCLUSIONS:In general, EOL RT was received infrequently, was delivered more commonly to younger patients with more advanced disease, and often was not completed as planned. There also was considerable variation in its use among National Comprehensive Cancer Network institutions. Next steps include expanding this research to other cancers and settings and investigating the clinical benefit of such treatment. Cancer 2012. © 2012 American Cancer Society.

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Tài liệu tham khảo

American Cancer Society, 2010, Cancer Facts & Figures 2010

National Center for Health Statistics, 2007, SEER 9 Areas and US Mortality Files 2007

10.1016/j.ijrobp.2007.04.059

10.1093/intqhc/mzi061

10.1177/082585970602200103

Horner MJ, 2009, SEER Cancer Statistics Review, 1975‐2006 [based on the November 2008 SEER data submission, posted to the SEER web site 2009]

10.1200/JCO.2001.19.1.137

10.1177/0269216310384900

10.1377/hlthaff.20.4.188

10.1056/NEJMoa1000678

10.1200/JCO.2001.19.14.3323

10.1200/JCO.2004.11.151

10.1378/chest.115.5.1232

10.1007/s00520-010-0983-x

10.1016/j.ijrobp.2008.12.084

10.1016/j.ijrobp.2006.04.005

10.1016/j.radonc.2004.12.013

10.1136/bmj.327.7408.195

10.1001/archinte.1988.00380120010003

10.1136/bmj.320.7233.469

10.1016/S0895-4356(96)00316-2

10.1002/cncr.25112

10.1200/JOP.0723601

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Cancer

Tập 118 Số 17

4339-4345

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