Stage III Non-small Cell Lung Cancer Management in England
Stage III Non-small Cell Lung Cancer Management in England
复制标题
DOI：
10.1016/j.clon.2019.07.020
复制
发表时间：
2019-10-01
影响因子：
3.4
通讯作者：
Harden, S., V
中科院分区：
文献类型：
--
作者：
Adizie, J. B.;Khakwani, A.;Harden, S., V
目的：我们提出了第一个分析的管理和结果的第三期非小细胞肺癌（NSCLC）在英格兰进行使用国家肺癌审计data.Materials和方法：患者诊断为第三期NSCLC在2016年确定。使用关联数据集（包括医院事件统计、国家放射治疗数据集、全身抗癌数据集、病理报告和死亡证明数据）对接受的治疗进行分类。Kaplan-Meier生存曲线，生存定义从诊断之日至死亡之日。结果：共6276例III期非小细胞肺癌进行了分析：3827期IIIA和2449期IIIB; 1047（17%）例患者进行了根治性放疗与676（11%）这些也接受化疗。20%的IIIA期疾病患者接受了手术，其中一半还接受了化疗，主要是在辅助治疗中进行。值得注意的是，2148例（34%）患者接受了姑息治疗，2265例（36%）患者未接受积极的抗癌治疗。1年生存率为32.9%（37.4%为IIIA期），最高的生存率为那些接受化疗和surgery.Conclusions的患者：我们强调在英格兰的III期非小细胞肺癌患者的最佳护理的重要差距。采用手术或根治性放疗结合化疗的多模式治疗方案的患者不到五分之一，尽管这些方案被认为是最佳方案。及时获得专家资源和工作人员，有效的共同决策和挑战偏见的做法有可能优化管理。(C)2019年皇家放射科医师学院。由爱思唯尔有限公司出版。保留所有权利。
Aims: We present the first analysis of the management and outcomes of stage III non-small cell lung cancer (NSCLC) conducted in England using National Lung Cancer Audit data.Materials and methods: Patients diagnosed with stage III NSCLC in 2016 were identified. Linked datasets (including Hospital Episode Statistics, the National Radiotherapy Dataset, the Systemic Anti-Cancer Dataset, pathology reports and death certificate data) were used to categorise the treatment received. Kaplan-Meier survival curves were obtained, with survival defined from the date of diagnosis to the date of death.Results: In total, 6276 cases of stage III NSCLC were analysed: 3827 stage IIIA and 2449 stage IIIB; 1047 (17%) patients were treated with radical radiotherapy with 676 (11%) of these also receiving chemotherapy. Twenty per cent of patients with stage IIIA disease underwent surgery, with half of these also receiving chemotherapy, predominantly delivered in the adjuvant setting. Of note, 2148 (34%) patients received palliative-intent treatment and 2265 (36%) received no active anti-cancer treatment. The 1-year survival was 32.9% (37.4% for stage IIIA), with the highest survival seen for those patients receiving chemotherapy and surgery.Conclusions: We highlight important gaps in the optimal care of patients with stage III NSCLC in England. Multimodality treatment with either surgery or radical radiotherapy combined with chemotherapy was delivered to less than one-fifth of patients, even though these regimens are considered optimal. Timely access to specialist resources and staff, the practice of effective shared decision making and challenging preconceptions have the potential to optimise management. (C) 2019 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.