Penetration of recommended procedures for lung cancer staging and management in the United States over 10 years

A quality research in radiation oncology survey

Ritsuko Komaki, Najma Khalid, Corey J. Langer, Feng Ming Kong, Jean B. Owen, Cheryl L. Crozier, J. Frank Wilson, Xiong Wei, Benjamin Movsas

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Purpose: To document the penetration of clinical trial results, practice guidelines, and appropriateness criteria into national practice, we compared the use of components of staging and treatment for lung cancer among patients treated in 2006-2007 with those used in patients treated in 1998-1999. Methods and Materials: Patient, staging work-up, and treatment characteristics were extracted from the process survey database of the Quality Research in Radiation Oncology (QRRO), consisting of records of 340 patients with locally advanced non-small cell lung cancer (LA-NSCLC) at 44 institutions and of 144 patients with limited-stage small cell lung cancer (LS-SCLC) at 39 institutions. Data were compared for patients treated in 2006-2007 versus those for patients treated in 1998-1999. Results: Use of all recommended procedures for staging and treatment was more common in 2006-2007. Specifically, disease was staged with brain imaging (magnetic resonance imaging or computed tomography) and whole-body imaging (positron emission tomography or bone scanning) in 66% of patients with LA-NSCLC in 2006-2007 (vs 42% in 1998-1999, P=.0001) and in 84% of patients with LS-SCLC in 2006-2007 (vs 58.3% in 1998-1999, P=.0011). Concurrent chemoradiation was used for 77% of LA-NSCLC patients (vs 45% in 1998-1999, P<.0001) and for 90% of LS-SCLC patients (vs 62.5% in 1998-1999, P<.0001). Use of the recommended radiation dose (59-74 Gy for NSCLC and 60-70 Gy as once-daily therapy for SCLC) did not change appreciably, being 88% for NSCLC in both periods and 51% (2006-2007) versus 43% (1998-1999) for SCLC. Twice-daily radiation for SCLC was used for 21% of patients in 2006-2007 versus 8% in 1998-1999. Finally, 49% of patients with LS-SCLC received prophylactic cranial irradiation (PCI) in 2006-2007 (vs 21% in 1998-1999). Conclusions: Although adherence to all quality indicators improved over time, brain imaging and recommended radiation doses for stage III NSCLC were used in <90% of cases. Use of full thoracic doses and PCI for LS-SCLC also requires improvement.

Original languageEnglish (US)
Pages (from-to)1082-1089
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume85
Issue number4
DOIs
StatePublished - Mar 15 2013

Fingerprint

Radiation Oncology
Neoplasm Staging
lungs
Lung Neoplasms
penetration
cancer
radiation
Research
Small Cell Lung Carcinoma
Non-Small Cell Lung Carcinoma
Cranial Irradiation
Radiation
dosage
brain
Neuroimaging
Surveys and Questionnaires
tomography
irradiation
Whole Body Imaging
Therapeutics

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Penetration of recommended procedures for lung cancer staging and management in the United States over 10 years : A quality research in radiation oncology survey. / Komaki, Ritsuko; Khalid, Najma; Langer, Corey J.; Kong, Feng Ming; Owen, Jean B.; Crozier, Cheryl L.; Wilson, J. Frank; Wei, Xiong; Movsas, Benjamin.

In: International Journal of Radiation Oncology Biology Physics, Vol. 85, No. 4, 15.03.2013, p. 1082-1089.

Research output: Contribution to journalArticle

Komaki, Ritsuko ; Khalid, Najma ; Langer, Corey J. ; Kong, Feng Ming ; Owen, Jean B. ; Crozier, Cheryl L. ; Wilson, J. Frank ; Wei, Xiong ; Movsas, Benjamin. / Penetration of recommended procedures for lung cancer staging and management in the United States over 10 years : A quality research in radiation oncology survey. In: International Journal of Radiation Oncology Biology Physics. 2013 ; Vol. 85, No. 4. pp. 1082-1089.
@article{a014560040ee46749ae1382e55525600,
title = "Penetration of recommended procedures for lung cancer staging and management in the United States over 10 years: A quality research in radiation oncology survey",
abstract = "Purpose: To document the penetration of clinical trial results, practice guidelines, and appropriateness criteria into national practice, we compared the use of components of staging and treatment for lung cancer among patients treated in 2006-2007 with those used in patients treated in 1998-1999. Methods and Materials: Patient, staging work-up, and treatment characteristics were extracted from the process survey database of the Quality Research in Radiation Oncology (QRRO), consisting of records of 340 patients with locally advanced non-small cell lung cancer (LA-NSCLC) at 44 institutions and of 144 patients with limited-stage small cell lung cancer (LS-SCLC) at 39 institutions. Data were compared for patients treated in 2006-2007 versus those for patients treated in 1998-1999. Results: Use of all recommended procedures for staging and treatment was more common in 2006-2007. Specifically, disease was staged with brain imaging (magnetic resonance imaging or computed tomography) and whole-body imaging (positron emission tomography or bone scanning) in 66{\%} of patients with LA-NSCLC in 2006-2007 (vs 42{\%} in 1998-1999, P=.0001) and in 84{\%} of patients with LS-SCLC in 2006-2007 (vs 58.3{\%} in 1998-1999, P=.0011). Concurrent chemoradiation was used for 77{\%} of LA-NSCLC patients (vs 45{\%} in 1998-1999, P<.0001) and for 90{\%} of LS-SCLC patients (vs 62.5{\%} in 1998-1999, P<.0001). Use of the recommended radiation dose (59-74 Gy for NSCLC and 60-70 Gy as once-daily therapy for SCLC) did not change appreciably, being 88{\%} for NSCLC in both periods and 51{\%} (2006-2007) versus 43{\%} (1998-1999) for SCLC. Twice-daily radiation for SCLC was used for 21{\%} of patients in 2006-2007 versus 8{\%} in 1998-1999. Finally, 49{\%} of patients with LS-SCLC received prophylactic cranial irradiation (PCI) in 2006-2007 (vs 21{\%} in 1998-1999). Conclusions: Although adherence to all quality indicators improved over time, brain imaging and recommended radiation doses for stage III NSCLC were used in <90{\%} of cases. Use of full thoracic doses and PCI for LS-SCLC also requires improvement.",
author = "Ritsuko Komaki and Najma Khalid and Langer, {Corey J.} and Kong, {Feng Ming} and Owen, {Jean B.} and Crozier, {Cheryl L.} and Wilson, {J. Frank} and Xiong Wei and Benjamin Movsas",
year = "2013",
month = "3",
day = "15",
doi = "10.1016/j.ijrobp.2012.10.016",
language = "English (US)",
volume = "85",
pages = "1082--1089",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Penetration of recommended procedures for lung cancer staging and management in the United States over 10 years

T2 - A quality research in radiation oncology survey

AU - Komaki, Ritsuko

AU - Khalid, Najma

AU - Langer, Corey J.

AU - Kong, Feng Ming

AU - Owen, Jean B.

AU - Crozier, Cheryl L.

AU - Wilson, J. Frank

AU - Wei, Xiong

AU - Movsas, Benjamin

PY - 2013/3/15

Y1 - 2013/3/15

N2 - Purpose: To document the penetration of clinical trial results, practice guidelines, and appropriateness criteria into national practice, we compared the use of components of staging and treatment for lung cancer among patients treated in 2006-2007 with those used in patients treated in 1998-1999. Methods and Materials: Patient, staging work-up, and treatment characteristics were extracted from the process survey database of the Quality Research in Radiation Oncology (QRRO), consisting of records of 340 patients with locally advanced non-small cell lung cancer (LA-NSCLC) at 44 institutions and of 144 patients with limited-stage small cell lung cancer (LS-SCLC) at 39 institutions. Data were compared for patients treated in 2006-2007 versus those for patients treated in 1998-1999. Results: Use of all recommended procedures for staging and treatment was more common in 2006-2007. Specifically, disease was staged with brain imaging (magnetic resonance imaging or computed tomography) and whole-body imaging (positron emission tomography or bone scanning) in 66% of patients with LA-NSCLC in 2006-2007 (vs 42% in 1998-1999, P=.0001) and in 84% of patients with LS-SCLC in 2006-2007 (vs 58.3% in 1998-1999, P=.0011). Concurrent chemoradiation was used for 77% of LA-NSCLC patients (vs 45% in 1998-1999, P<.0001) and for 90% of LS-SCLC patients (vs 62.5% in 1998-1999, P<.0001). Use of the recommended radiation dose (59-74 Gy for NSCLC and 60-70 Gy as once-daily therapy for SCLC) did not change appreciably, being 88% for NSCLC in both periods and 51% (2006-2007) versus 43% (1998-1999) for SCLC. Twice-daily radiation for SCLC was used for 21% of patients in 2006-2007 versus 8% in 1998-1999. Finally, 49% of patients with LS-SCLC received prophylactic cranial irradiation (PCI) in 2006-2007 (vs 21% in 1998-1999). Conclusions: Although adherence to all quality indicators improved over time, brain imaging and recommended radiation doses for stage III NSCLC were used in <90% of cases. Use of full thoracic doses and PCI for LS-SCLC also requires improvement.

AB - Purpose: To document the penetration of clinical trial results, practice guidelines, and appropriateness criteria into national practice, we compared the use of components of staging and treatment for lung cancer among patients treated in 2006-2007 with those used in patients treated in 1998-1999. Methods and Materials: Patient, staging work-up, and treatment characteristics were extracted from the process survey database of the Quality Research in Radiation Oncology (QRRO), consisting of records of 340 patients with locally advanced non-small cell lung cancer (LA-NSCLC) at 44 institutions and of 144 patients with limited-stage small cell lung cancer (LS-SCLC) at 39 institutions. Data were compared for patients treated in 2006-2007 versus those for patients treated in 1998-1999. Results: Use of all recommended procedures for staging and treatment was more common in 2006-2007. Specifically, disease was staged with brain imaging (magnetic resonance imaging or computed tomography) and whole-body imaging (positron emission tomography or bone scanning) in 66% of patients with LA-NSCLC in 2006-2007 (vs 42% in 1998-1999, P=.0001) and in 84% of patients with LS-SCLC in 2006-2007 (vs 58.3% in 1998-1999, P=.0011). Concurrent chemoradiation was used for 77% of LA-NSCLC patients (vs 45% in 1998-1999, P<.0001) and for 90% of LS-SCLC patients (vs 62.5% in 1998-1999, P<.0001). Use of the recommended radiation dose (59-74 Gy for NSCLC and 60-70 Gy as once-daily therapy for SCLC) did not change appreciably, being 88% for NSCLC in both periods and 51% (2006-2007) versus 43% (1998-1999) for SCLC. Twice-daily radiation for SCLC was used for 21% of patients in 2006-2007 versus 8% in 1998-1999. Finally, 49% of patients with LS-SCLC received prophylactic cranial irradiation (PCI) in 2006-2007 (vs 21% in 1998-1999). Conclusions: Although adherence to all quality indicators improved over time, brain imaging and recommended radiation doses for stage III NSCLC were used in <90% of cases. Use of full thoracic doses and PCI for LS-SCLC also requires improvement.

UR - http://www.scopus.com/inward/record.url?scp=84875229755&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875229755&partnerID=8YFLogxK

U2 - 10.1016/j.ijrobp.2012.10.016

DO - 10.1016/j.ijrobp.2012.10.016

M3 - Article

VL - 85

SP - 1082

EP - 1089

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 4

ER -