Trends and variations in treatment of stage I?III non-small cell lung cancer from 2008 to 2018: A nationwide population-based study from the Netherlands

Introduction: This Dutch population-based study describes nationwide treatment patterns and its variations for stage I-III non-small cell lung cancer (NSCLC).Materials and methods: Patients diagnosed with clinical stage I-III NSCLC in the period 2008-2018 were selected from the Netherlands Cancer Registry. Treatment trends were studied over time and age groups. Use of radiotherapy versus surgery (stage I-II), and concurrent versus sequential chemoradiotherapy (stage III) were analyzed by logistic regression.Results: In stage I, the rate of surgery decreased from 58 % (2008) to 40 % (2018) whil... Mehr ...

Verfasser: Evers, J.
de Jaeger, K.
Hendriks, L.E.L.
van der Sangen, M.
Terhaard, C.
Siesling, S.
De Ruysscher, D.
Struikmans, H.
Aarts, M.J.
Dokumenttyp: Artikel
Erscheinungsdatum: 2021
Reihe/Periodikum: Evers , J , de Jaeger , K , Hendriks , L E L , van der Sangen , M , Terhaard , C , Siesling , S , De Ruysscher , D , Struikmans , H & Aarts , M J 2021 , ' Trends and variations in treatment of stage I?III non-small cell lung cancer from 2008 to 2018: A nationwide population-based study from the Netherlands ' , Lung Cancer , vol. 155 , pp. 103-113 . https://doi.org/10.1016/j.lungcan.2021.03.013
Schlagwörter: Radiation oncology / Patterns of care / Non-small cell lung cancer / Epidemiology / Treatment trends / Treatment variation / STEREOTACTIC BODY RADIOTHERAPY / TREATMENT OUTCOMES / ELDERLY-PATIENTS / ABLATIVE RADIOTHERAPY / RADIATION-THERAPY / UPDATED DATA / SURGERY / SURVIVAL / CARE
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29186374
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://cris.maastrichtuniversity.nl/en/publications/05d21320-ffb0-4544-8aa1-32859c6ac973

Introduction: This Dutch population-based study describes nationwide treatment patterns and its variations for stage I-III non-small cell lung cancer (NSCLC).Materials and methods: Patients diagnosed with clinical stage I-III NSCLC in the period 2008-2018 were selected from the Netherlands Cancer Registry. Treatment trends were studied over time and age groups. Use of radiotherapy versus surgery (stage I-II), and concurrent versus sequential chemoradiotherapy (stage III) were analyzed by logistic regression.Results: In stage I, the rate of surgery decreased from 58 % (2008) to 40 % (2018) while radiotherapy use increased over time (from 31 % to 52 %), which mostly concerned stereotactic body radiotherapy (74 %). In stage II, 54 % of patients received surgery, and use of radiotherapy alone increased from 18 % to 25 %. The strongest factors favoring radiotherapy over surgery were WHO performance status (OR > 2 vs 0: 23.39 (95% CI: 18.93-28.90)), increasing age (OR > 80 vs <60 years: 14.52 (95% CI: 13.02-16.18)) and stage (OR stage II vs I: 0.61 (95% CI: 0.57-0.65)). In stage III, the combined use of chemotherapy and radiotherapy increased from 35 % (2008) to 39 % (2018). In all years, 23 % received concurrent chemoradiotherapy, 9 % sequential chemoradiotherapy, 23 % radiotherapy or chemotherapy alone, and 25 % best supportive care. The strongest factors favoring concurrent over sequential chemoradiotherapy were age (OR > 80 vs <60 years: 0.14 (95% CI: 0.10-0.19)), WHO Performance status (OR > 2 vs 0: 0.33 (95% CI: 0.24-0.47)) and region (OR east vs north: 0.39 (95% CI: 0.30-0.50)).Conclusions: The use of radiotherapy became more prominent over time in stage I NSCLC. Combined use of chemotherapy and radiotherapy marginally increased in stage III: only one third of patients received chemoradiotherapy, mainly concurrently. Treatment variation seen between patient groups suggests tailored treatment decision, while variation between hospitals and regions indicate differences in clinical practice.