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  P2.24 - Poster Session 2 - Supportive Care (ID 157)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11996

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    P2.24-050 - Treatment pathways of patients diagnosed with non-small cell lung cancer - an audit of practice at a regional teaching hospital. (ID 3058)

    09:30 - 09:30  |  Author(s): C.J. Hunter
    • Abstract

    Background
    Lung cancer is the main cause of cancer death for both men and women in Australia. Non-small cell lung cancer (NSCLC) usually presents late in the disease when treatment options are limited. Surgery remains the main stay of curative treatment with definitive radiotherapy or chemoradiotherapy used in some patients unfit for surgery or with locally advanced disease. Increasing use of chemotherapy with introduction of new targeted therapies has broadened the therapeutic choices for patients. We wished to look at what happened to patients with NSCLC in our hospital (RHH)

    Methods
    An audit was performed of patients presenting at our MDT (at which all patients with lung cancer in southern Tasmania are discussed) in 2010 and 2011 with a diagnosis of NSCLC. We looked at the type of therapy assigned (or not) and where they had chemotherapy the number of lines and types of treatment given.

    Results
    177 patients presented with NSCLC. Histology showed 99 adenocarcinomas, 48 squamous cell, 20 NSCLC-NOS, 5 large cell neuroendocrine, 3 adenosquamous cell and 2 with synchronous primaries. 48 (27%) patients received no treatment beyond palliative care. Mostly this was due to comorbidities or patient wishes (8) but 13 (7%) patients died around the time of diagnosis. 38 (21%) patients underwent surgery (3 pneumonectomies, 31 lobectomies and 4 wedge resections). 3 had adjuvant radiotherapy and 5 had adjuvant chemotherapy. 79 (45%) patients under went radiotherapy: 59 had palliative radiotherapy, 12 chemoradiotherapy, 4 definitive radiotherapy, 1 brachytherapy and 3 had adjuvant radiotherapy to surgery. 84 (47%) were reviewed by medical oncologist of whom 56 (32% of total, 67% of those reviewed) received some form of 1[st] line chemotherapy. There were 13 different regimens of first line therapy, most common being carboplatin/gemcitabine (n=19) and carboplatin/vinorelbine (n=10). The reason for choice of therapy was not usually stated and varied between specialists but individual specialists also varied regimens used. 22 patients had 2nd line therapy, 12 patients had 3[rd] line and 5 patients had 4[th] line. 16 patients had pemetrexed maintenance therapy (1 in combination with carboplatin) of which 9 received 3 or less cycles, 1 patient received 26 cycles. 13 (7%) patients received erlotinib. The patients were reviewed by 7 different specialists (3 were seen elsewhere in the state) with one specialist seeing 36 patients but 4 seeing less than 10 over the 2 year period.

    Conclusion
    The majority of our patients received some form of therapy. Our radiotherapy usage is below expected numbers and chemotherapy usage is particularly low. This may reflect our patients’ demographics. The wide variety of first line regimens used makes over all conclusions about the effect of chemotherapy difficult. A number of medical oncologists treat less than 5 patients with lung cancer a year. Consolidation of care to a smaller number of specialists should be considered.