Author of

• 12853

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  P3.24 - Poster Session 3 - Supportive Care (ID 160)

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

  • 12860

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    P3.24-007 - Do patients discussed at Lung Cancer Multidisciplinary Team Meetings receive guideline-recommended treatment? (ID 321)

    09:30 - 09:30  |  Author(s): M.M. Boxer
    • Abstract

    Background
    Many clinical practice guidelines recommend that all lung cancer patients should be discussed at a multidisciplinary team meeting (MDM) to determine a management plan. Previous studies have shown that lung cancer MDM recommendations are largely concordant with guidelines. There are limited data on whether these recommendations are translated into actual treatment received. The aim of this study was to evaluate whether patients discussed at a lung cancer MDM actually received guideline-recommended treatment (GRT) and determine reasons for not receiving GRT.

    Methods
    The Liverpool/Macarthur lung cancer MDM prospectively collects data on new lung cancer patients including patient and tumour characteristics, staging investigations, referrals and treatment recommendations. All new lung cancer patients discussed at the MDM between 1/12/05 – 31/12/2010 were identified. Details of patient demographics, tumour characteristics and treatment were obtained from the MDM database and the Area Clinical Cancer Registry. GRT was assigned to each patient according to pathology, stage and ECOG performance status as per the 2004 Australian Lung Cancer Guidelines. This was compared to actual treatment received to determine adherence to GRT. For those who did not receive GRT, the medical record was reviewed to determine the reason why. Survival was compared between patients who did and did not receive GRT.

    Results
    808 patients were discussed at the MDM. 64% were male and the median age was 68 years. Pathology was NSCLC in 657 (81%), SCLC in 119 (15%) and not confirmed in 32 (4%). 128 (16%) had Stage I or II NSCLC, 306 (38%) Stage III NSCLC or limited stage SCLC and 372 (46%) metastatic disease. GRT could be assigned in 98% of patients who had both stage and ECOG performance status documented. Overall 411 (51%) of patients received GRT, and 380 (47%) did not receive GRT. The main reasons for not receiving GRT were decline in performance status (24%), large tumour volume precluding radical RT (17%), co-morbidities (14%) and patient preference (13%). On multivariate analysis, ECOG performance status, stage and age were significantly associated with receipt of GRT. GRT, ECOG performance status and stage were significant predictors of survival.

    Conclusion
    Despite discussion at an MDM, a significant proportion of patients were unable to receive GRT due to legitimate reasons. This may reflect the characteristics of the underlying lung cancer population who are older and have coexisting comorbidities. Alternative treatment strategies are needed for patients who are not suitable for GRT.