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P. Beckett
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P1.05 - Early Stage NSCLC (ID 691)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.05-010 - Curative Treatment Rates for Patients Diagnosed with Early Stage Non-Small Cell Lung Cancer (NSCLC) in England (ID 9889)
09:30 - 09:30 | Author(s): P. Beckett
- Abstract
Background:
Overall survival for lung cancer in England has previously been shown to be improving year on year and to correlate with surgical resection rates (National Lung Cancer Audit (NLCA) 2016 report). Recently the NLCA switched to use anonymised data collected and processed by the National Cancer Registration and Analysis Service (NCRAS) which has allowed linkage of the dataset to other national datasets including the radiotherapy dataset (RTDS), not previously reported. The main aim of this study was to identify a national curative treatment rate for early stage NSCLC and to identify which patient features influence whether a patient receives surgery, radical radiotherapy (RT) or no active treatment.
Method:
A cross-sectional analysis was conducted on all English patients diagnosed with stage I-II lung cancer between January 2015 and December 2015. Types of surgery and radical radiotherapy were identified from NCRAS databases including Cancer Outcomes and Services Dataset (COSD), Hospital Episode Statistics (HES) and RTDS databases. Survival was defined from time from treatment until death and Cox regression analysis was used to determine factors associated with survival.
Result:
36025 cases of lung cancer were identified in 2015 with 8841 (28%) cases of stage IA-IIB proven or presumed NSCLC. 4560 (51.6%) cases received surgery and 1437 (16.2%) received radical RT creating a combined total of 5997 (67.8%) cases receiving treatment with curative intent. Curative intent treatment varied across cancer networks from 61.6% to 74.4%. Stereotactic Ablative Radiotherapy (SABR) was delivered in 750/1437 (52.2%) radical RT cases, generally for stage I disease, 60/1437 (4.1%) cases received Continuous Hyper-fractionated Accelerated RT (CHART) and 486/1437 (33.8%) cases received 55Gy/20 fractions, a commonly prescribed hypo-fractionated radical RT regime in England. Notably, 2844 (32.2%) patients did not receive treatment with curative intent, receiving either palliative therapy or supportive care only. Lack of treatment with curative intent was associated with increasing age and worsening performance status and varied across networks (25.6% - 38.4%). Updated survival data will be presented.
Conclusion:
In England for 2015, the curative treatment rate for stage I and II NSCLC was 67.8%. This means that almost one third of patients did not receive definitive treatment for their early stage lung cancer, ranging from 25.6% to 38.4 % across networks. A NLCA deep dive spotlight audit to identify more details about why these patients did not receive definitive treatment is planned for later this year.
