Do patients discussed at a lung cancer multidisciplinary team meeting receive guideline‐recommended treatment?

Boxer, Miriam M; Duggan, Kirsten J; Descallar, Joseph; Vinod, Shalini

doi:10.1111/ajco.12421

Cited by 20 publications

(48 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These largely relate to tumour location and size, which affect the ability to deliver a curative dose of radiotherapy. Large tumour volume precluding curative radiotherapy was found to be a reason in 17% of patients not receiving GRT by Boxer et al [11]. There may be similar reasons contraindicating surgery in a small proportion of cases, although radiotherapy would be an alternative treatment option in these patients.…”

Section: Tumour Factorsmentioning

confidence: 96%

“…Boxer et al [11] evaluated whether treatment of patients discussed at a lung cancer multidisciplinary team meeting in Australia were concordant with local guidelines ( Table 1). The overall concordance with GRT was 52%.…”

Section: Concordance Of Clinical Practice With Guidelinesmentioning

confidence: 99%

“…Boxer et al [11] also researched the reasons behind the lack of GRT in their cohort of 808 lung cancer patients discussed at a lung cancer multidisciplinary meeting. Fifty-two per cent of patients were treated according to published Australian guidelines.…”

Section: Patient Factorsmentioning

confidence: 99%

“…Boxer et al [11] found that patient preference accounted for 13% of reasons for non-receipt of GRT. Patient refusal has been documented in 20% of patients offered surgery [24] and 32% offered radiotherapy [28] in selected populations.…”

Section: Patient Factorsmentioning

confidence: 99%

See 3 more Smart Citations

Decision Making in Lung Cancer – How Applicable are the Guidelines?

Vinod

2015

Clinical Oncology

View full text Add to dashboard Cite

Section: Tumour Factorsmentioning

confidence: 96%

Section: Concordance Of Clinical Practice With Guidelinesmentioning

confidence: 99%

Section: Patient Factorsmentioning

confidence: 99%

Section: Patient Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Decision Making in Lung Cancer – How Applicable are the Guidelines?

Vinod

2015

Clinical Oncology

View full text Add to dashboard Cite

“…Multidisciplinary care for lung cancer is accepted in many countries around the world but collection of data by multidisciplinary team (MDT) is not yet routine or standardized. Data sources that provide information on the impact of MDT care include state cancer registries, local cancer registries, hospital‐based registries and (via linkage) national administrative data sets .…”

Section: Introductionmentioning

confidence: 99%

Consensus minimum data set for lung cancer multidisciplinary teams: Results of a Delphi process

et al. 2018

View full text Add to dashboard Cite

show abstract

Can reducing planning safety margins broaden the inclusion criteria for lung stereotactic ablative body radiotherapy?

Ghandourh

Batumalai

Boxer

et al. 2021

J of Medical Radiation Sci

View full text Add to dashboard Cite

Introduction: Stereotactic ablative body radiotherapy (SABR) is currently indicated for inoperable, early-stage non-small cell lung carcinoma (NSCLC). Advancements in image-guidance technology continue to improve treatment precision and enable reductions in planning safety margins. We investigated the dosimetric benefits of margin reduction, its potential to extend SABR to more NSCLC patients and the factors influencing plan acceptability. Methods: This retrospective analysis included 61 patients (stage IA-IIIA) treated with conventional radiotherapy. Patients were ineligible for SABR due to tumour size or proximity to organs at risk (OAR). Using Pinnacle auto-planning, three SABR plans were generated for each patient: a regular planning target volume margin plan, a reduced margin plan (gross tumour volume GTV+3 mm) and a non-margin plan. Targets were planned to 48Gy/4 or 50Gy/5 fractions depending on location. Plans were compared in terms of target coverage, OAR doses and dosimetric acceptability based on local guidelines. Predictors of acceptability were investigated using logistic regression analysis. Results: Compared to regular margin plans, both reduced margin and non-margin plans resulted in significant reductions to almost all dose constraints. Dose conformity was significantly worse in non-margin plans (P < 0.05) and strongly correlated with targets' surface area/volume ratio (R 2 = 0.9, P < 0.05). 26% of reduced margin plans were acceptable, compared to 54% of non-margin plans. GTV overlap with OARs significantly affected plan acceptability (OR 0.008, 95% CI 0.001-0.073). Conclusion: Margin reduction significantly reduced OAR doses enabling acceptable plans to be achieved for patients previously excluded from SABR. Indications for lung SABR may broaden as treatment accuracy continues to improve; further work is needed to identify patients most likely to benefit.

show abstract

Do patients discussed at a lung cancer multidisciplinary team meeting receive guideline‐recommended treatment?

Abstract: A significant proportion of lung cancer patients did not receive guideline-recommended treatment due to legitimate reasons. Alternative guidelines are needed for patients not suitable for current best practice. Treatment according to guidelines was a predictor for survival.

Cited by 20 publications

References 19 publications

Decision Making in Lung Cancer – How Applicable are the Guidelines?

Decision Making in Lung Cancer – How Applicable are the Guidelines?

Consensus minimum data set for lung cancer multidisciplinary teams: Results of a Delphi process

Can reducing planning safety margins broaden the inclusion criteria for lung stereotactic ablative body radiotherapy?

Contact Info

Product

Resources

About