Resources and management strategies for the use of radiotherapy in the treatment of lung cancer in Central and Eastern European countries: Results of an International Atomic Energy Agency (IAEA) survey

Kępka, Lucyna; Данилова, В П; Saghatelyan, Tatul; Bajcsay, András; Utehina, O.; Stojanović, S; Yalman, Deniz; Demiral, Ayşe; Bondaruk, Olga; Kuddu, Maire; Jeremić, Branislav

doi:10.1016/j.lungcan.2006.12.011

Cited by 24 publications

(16 citation statements)

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“…with fraction dose of 1.8-2.0 Gy), prolonged (44 days) RT after completion of CHT [11], which makes combined treatment significantly longer. Moreover, twice-daily irradiation is costly, logistically challenging and usually requires hospitalisation, which precludes the adoption of this schedule as a standard regimen in most cancer centres in the world [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Hypofractionated Conformal Radiotherapy in Combination with Chemotherapy in Limited Disease Small Cell Lung Cancer Patients

Socha

Guzowska²,

Tyc-Szczepaniak

et al. 2014

Advances in Respiratory Medicine

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Aim: To evaluate the results of hypofractionated conformal radiotherapy (RT) in limited disease small cell lung cancer (LD-SCLC) patients, with particular interest in the value of “early” RT, i.e., given before the 3rd chemotherapy (CHT) cycle. Material and Methods: Outcome of hypofractionated RT (42 Gy, 2.8 Gy/fraction, given over 19–21 days, using “concomitant boost” technique—elective volume [39 Gy, 2.6 Gy/fraction] and tumour volumes treated during the same fraction) combined with CHT in 100 consecutive LD-SCLC patients, was retrospectively assessed. The outcomes were compared with a previously published series of 117 LD-SCLC patients treated in the same institution with hyperfractionated or conventionally fractionated RT. Results: Forty-two patients (42%) received “early” RT. Grade 3 NCI CTC acute oesophageal toxicity appeared in 5% of patients. There were three treatment-related deaths. Three-year overall survival (OS) rate was 39.4%, median—24 months in the examined group vs. 26.0%, and 18 months in historical control, p = 0.02. Three-year OS for 78 patients with completed CHT was 42.2%, median—28 months vs. 30%, and 14 months for 22 patients who received ≤ 3 CHT cycles, (p = 0.03). The actuarial 3-year locoregional failure risk (LRFR) was 34.0% in the examined group vs. 51.0% in the historical control, p = 0.04. Multivariate analysis showed a marginally significant correlation between the “early” use of RT and LRFR: RR = 0.43 (95% CI: 0.17–1.04), p = 0.06, with no significant impact on OS. Conclusions: Shorter duration of RT using hypofractionation results in encouraging outcomes and acceptable toxicity. Completion of all planned CHT cycles is the most important factor for OS.

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Section: Introductionmentioning

confidence: 99%

Hypofractionated Conformal Radiotherapy in Combination with Chemotherapy in Limited Disease Small Cell Lung Cancer Patients

Socha

Guzowska²,

Tyc-Szczepaniak

et al. 2014

Advances in Respiratory Medicine

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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%

“…Evidence has been published on the benefits of early RT administration in this situation [11]. Among various RT schedules used to treat LC with palliative intent, the most frequent was 300 cGy × 10 fractions.…”

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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“…Concurrent chemo-radiation is considered the optimal curative treatment for unresected advanced non-small cell lung cancer [37]. Among the developing countries participating in this study, sequential chemo-radiation (57%) was used far more often than concurrent chemo-radiation (10%) for non-small cell lung cancer, the opposite of reported patterns of practice in the United States [38,39]. …”

Section: Discussionmentioning

confidence: 99%

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

Hanna¹,

Kangolle

2010

BMC Int Health Hum Rights

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BackgroundCancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas.DiscussionThis article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes.SummaryThere is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important.

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Resources and management strategies for the use of radiotherapy in the treatment of lung cancer in Central and Eastern European countries: Results of an International Atomic Energy Agency (IAEA) survey

Cited by 24 publications

References 50 publications

Hypofractionated Conformal Radiotherapy in Combination with Chemotherapy in Limited Disease Small Cell Lung Cancer Patients

Hypofractionated Conformal Radiotherapy in Combination with Chemotherapy in Limited Disease Small Cell Lung Cancer Patients

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

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

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