I Walraven1, R A Damhuis2, M G Ten Berge3, M Rosskamp4, L van Eycken4, D de Ruysscher5, J S A Belderbos6. 1. Department of Radiation Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 2. Department of Research, Comprehensive Cancer Association, The Netherlands, Utrecht, The Netherlands. 3. Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands. 4. Belgian Cancer Registry, Brussels, Belgium. 5. Department of Radiation Oncology (MAASTRO Clinic), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Radiation Oncology, KU Leuven, Belgium. 6. Department of Radiation Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: j.belderbos@nki.nl.
Abstract
AIMS: Concurrent chemoradiotherapy (CCRT) is considered the standard treatment regimen in non-surgical locally advanced non-small cell lung cancer (NSCLC) patients and sequential chemoradiotherapy (SCRT) is recommended in patients who are unfit to receive CCRT or when the treatment volume is considered too large. In this study, we investigated the proportion of CCRT/SCRT in the Netherlands and Belgium. Furthermore, patient and disease characteristics associated with SCRT were assessed. MATERIALS AND METHODS: An observational study was carried out with data from three independent national registries: the Belgian Cancer Registry (BCR), the Netherlands Cancer Registry (NCR) and the Dutch Lung Cancer Audit-Radiotherapy (DLCA-R). Differences in patient and disease characteristics between CCRT and SCRT were tested with unpaired t-tests (for continuous variables) and with chi-square tests (for categorical variables). A prognostic model was constructed to determine patient and disease parameters predictive for the choice of SCRT. RESULTS: This study included 350 patients from the BCR, 780 patients from the NCR and 428 patients from the DLCA-R. More than half of the stage III NSCLC patients in the Netherlands (55%) and in Belgium more than a third (35%) were treated with CCRT. In both the Dutch and Belgian population, higher age and more advanced N-stage were significantly associated with SCRT. Performance score, pulmonary function, comorbidities and tumour volume were not associated with SCRT. CONCLUSION: In this observational population-based study, a large treatment variation in non-surgical stage III NSCLC patients was observed between and within the Netherlands and Belgium. Higher age and N-stage were significantly associated with the choice for SCRT.
AIMS: Concurrent chemoradiotherapy (CCRT) is considered the standard treatment regimen in non-surgical locally advanced non-small cell lung cancer (NSCLC) patients and sequential chemoradiotherapy (SCRT) is recommended in patients who are unfit to receive CCRT or when the treatment volume is considered too large. In this study, we investigated the proportion of CCRT/SCRT in the Netherlands and Belgium. Furthermore, patient and disease characteristics associated with SCRT were assessed. MATERIALS AND METHODS: An observational study was carried out with data from three independent national registries: the Belgian Cancer Registry (BCR), the Netherlands Cancer Registry (NCR) and the Dutch Lung Cancer Audit-Radiotherapy (DLCA-R). Differences in patient and disease characteristics between CCRT and SCRT were tested with unpaired t-tests (for continuous variables) and with chi-square tests (for categorical variables). A prognostic model was constructed to determine patient and disease parameters predictive for the choice of SCRT. RESULTS: This study included 350 patients from the BCR, 780 patients from the NCR and 428 patients from the DLCA-R. More than half of the stage III NSCLCpatients in the Netherlands (55%) and in Belgium more than a third (35%) were treated with CCRT. In both the Dutch and Belgian population, higher age and more advanced N-stage were significantly associated with SCRT. Performance score, pulmonary function, comorbidities and tumour volume were not associated with SCRT. CONCLUSION: In this observational population-based study, a large treatment variation in non-surgical stage III NSCLCpatients was observed between and within the Netherlands and Belgium. Higher age and N-stage were significantly associated with the choice for SCRT.
Authors: Merle I Ronden; Idris Bahce; Niels J M Claessens; Nicole Barlo; Max R Dahele; Johannes M A Daniels; Caroline Tissing-Tan; Edo Hekma; Sayed M S Hashemi; Antoinet van der Wel; Femke O B Spoelstra; Wilko F A R Verbakel; Marian A Tiemessen; Marjolein van Laren; Annemarie Becker; Svitlana Tarasevych; Cornelis J A Haasbeek; Karen Maassen van den Brink; Chris Dickhoff; Suresh Senan Journal: JTO Clin Res Rep Date: 2021-06-06