What Is the Optimal Radiotherapy Utilization Rate for Lung Cancer? a Systematic Review

Liu, W.; Liu, A.; Boldt, Gabriel; Schuffenegger, P. Munoz; Louie, Alexander V.

doi:10.1016/j.ijrobp.2019.06.1512

Cited by 3 publications

(5 citation statements)

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“…A systematic review has suggested that the lifetime ORUR for all lung cancer patients is between 61-82%, and that most studies consistently show underutilization. Actuarial utilization rates of radiotherapy in patients with metastatic disease ranged from 17-47% (40). Our results fortunately report a higher utilization rate for palliative thoracic radiotherapy, in that 53.1% of all metastatic NSCLC patients, and 56.1% of those reporting a moderate-tosevere dyspnea score received therapy.…”

Section: Factors Associated With Receipt Of Therapy In Moderate-tosev...mentioning

confidence: 51%

Dyspnea in patients with stage IV non-small cell lung cancer: a population-based analysis of disease burden and patterns of care

Yan¹,

Tjong²,

Chan³

et al. 2023

J Thorac Dis

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Background: Patients with metastatic non-small cell lung cancer (NSCLC) experience significant morbidity with dyspnea being a common symptom with a prevalence of 70%. The objective of this study was to determine factors associated with a moderate-to-severe dyspnea score based on the Edmonton Symptom Assessment System (ESAS), as well as resultant patterns of intervention and factors correlated to intervention receipt.Methods: Using health services administrative data, we conducted a population-based study of all patients diagnosed with metastatic NSCLC treated from January 2007 to September 2018 in the province of Ontario.The primary outcomes of interest are the prevalence of moderate-to-severe dyspnea scores, and the receipt of dyspnea-directed intervention. Differences in baseline characteristic between moderate-to-severe dyspnea and low dyspnea score cohorts were assessed by comparative statistics. Predictors of intervention receipt for patients with moderate-to-severe dyspnea scores were estimated using multivariable modified Poisson regression.Results: The initial study cohort included 13,159 patients diagnosed with metastatic NSCLC and of these, 9,434 (71.7%) reported a moderate-to-severe dyspnea score. Compared to patients who did not report moderateto-severe dyspnea scores, those who reported a moderate-to-severe dyspnea score were more likely to complete a greater number of ESAS surveys, be male, have a higher Elixhauser comorbidity index (ECI) score, and receive subsequent systemic therapy after diagnosis. Most patients with a moderate-to-severe dyspnea score received intervention (96%), of which the most common were palliative care management (87%), thoracic radiotherapy (56%) and thoracentesis (37%). Multivariable regression identified older patients to be less likely to undergo pleurodesis. Thoracentesis was less common for patients living in rural and non-major urban areas, lower income areas, and earlier year of diagnosis. Receipt of thoracic radiotherapy was less common for older patients, females, those with ECI ≥4, patients living in major urban areas, and those with later year of diagnosis. Finally, palliative care referrals were less frequent for patients with ECI ≥4, age 60-69, residence outside of major urban areas, earlier year of diagnosis, and lower income areas.

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Section: Factors Associated With Receipt Of Therapy In Moderate-tosev...mentioning

confidence: 51%

Dyspnea in patients with stage IV non-small cell lung cancer: a population-based analysis of disease burden and patterns of care

Yan¹,

Tjong²,

Chan³

et al. 2023

J Thorac Dis

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“…Despite marked increases in lung SABR utilisation rates over time, our analysis shows they remain short of meeting the evidence-based population demand. This gap between actual and optimal utilisation is also evident by the notable proportion of patients with potentially curable lesions receiving palliative or no treatment at all [10][11][12]. Underutilisation of radiotherapy has been linked to considerable reductions in overall survival and loss of years-of-potential life [10,16,66].…”

Section: Discussionmentioning

confidence: 99%

“…In Australia, 57% of patients with inoperable stage I-II NSCLC receive radical radiotherapy (14% of whom had SABR) [11]. A recent systematic review of population-based studies estimated utilisation of curative-intent RT to range between 8 and 21% for stage I-III NSCLC [12]. Cohorts that included both operable and inoperable stage I patients reported lower rates of SABR utilisation at approximately 6-13% [34][35][36].…”

Section: Actual Vs Optimal Sabr Utilisationmentioning

confidence: 99%

“…Practice pattern studies have revealed wide variations in radiotherapy utilisation across different populations as well as service providers [10][11][12][13][14][15], highlighting the need for establishing valid benchmarks of optimal utilisation rates that reflect actual demands within the population. Evidence-based models have previously been used to determine optimal utilisation rates for different radiotherapy and chemotherapy treatments [3,16,17].…”

Section: Introductionmentioning

confidence: 99%

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Optimal and actual rates of Stereotactic Ablative Body Radiotherapy (SABR) utilisation for primary lung cancer in Australia

Ghandourh

Holloway

Batumalai

et al. 2022

Clinical and Translational Radiation Oncology

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“…Radiotherapy as a component of treatment for lung cancer involves both clinical decision making and technical aspects which are potentially and readily measurable components of the process of care. Whilst studies have shown the optimal utilisation of radiotherapy should account for 61-82% of all treatments received by lung cancer patients [5], only 6% of QIs in lung cancer reported in the literature are related to the use of radiotherapy [1]. Considering radiotherapy is an important part of treatment determining health outcomes for a large number of lung cancer patients, there is a relative limited number of developed indicators to measure the quality of radiotherapy received by patients in realworld health services.…”

Section: Introductionmentioning

confidence: 99%

The development of radiotherapy quality indicators for lung cancer- a modified Delphi technique protocol

Chiew¹,

Donnelly

Harden

et al. 2022

Preprint

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Background Radiotherapy is an effective evidence-based treatment modality for the definitive management of both early and locally advanced lung cancer. Whilst the literature reports a wide range of quality indicators (QIs) to assess the surgical management of lung cancer there is a deficit of robust QIs available to measure the quality of radiotherapy received by patients[1]. We propose a literature review and modified Delphi technique to develop a set of radiotherapy specific quality indicators and benchmarks aimed at evaluating the processes involved in the planning and delivery of radiotherapy for lung cancer. Methods A modified Delphi technique will be used and will include an international expert panel in two formal rounds with a target of 40 participants and intervening steering committee review with a minimum of 9 stakeholders. Candidate radiotherapy QIs will be selected from literature review and assessed by a steering committee to be included in the Delphi process. Both QIs and proposed benchmarks will be ranked by the expert panel in 2 rounds and included in the final set of QIs if a pre-defined consensus definition for importance is met by at least 70% of responses with a score of 7 or more on a 9-point Likert scale. Consensus criteria for feasibility and proposed benchmarks will be achieved if at least 70% of responses are reported as 3 or more on a 3-point Likert scale. Discussion We aim to address the current lack of quality indicators for assessing radiotherapy in lung cancer by using a robust modified Delphi method to attain international expert consensus for a set of QIs specific to the process involved in planning and delivering radiotherapy for definitive management of lung cancer. These have the potential to provide a foundation for QI measurement and benchmarking to guide quality improvement in radiotherapy for lung cancer.

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What Is the Optimal Radiotherapy Utilization Rate for Lung Cancer? a Systematic Review

Cited by 3 publications

References 0 publications

Dyspnea in patients with stage IV non-small cell lung cancer: a population-based analysis of disease burden and patterns of care

Dyspnea in patients with stage IV non-small cell lung cancer: a population-based analysis of disease burden and patterns of care

Optimal and actual rates of Stereotactic Ablative Body Radiotherapy (SABR) utilisation for primary lung cancer in Australia

The development of radiotherapy quality indicators for lung cancer- a modified Delphi technique protocol

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