Current patterns of care for patients with extensive stage small cell lung cancer: Survey of US radiation oncologists on their recommendations regarding thoracic consolidation radiotherapy

Timur Mitin, Aditya Jain, Catherine Degnin, Yiyi Chen, Mark Henderson, Charles Thomas

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives Current National Comprehensive Cancer Network (NCCN) guidelines recommend thoracic consolidation radiation therapy (TCRT) for patients with Extensive Stage Small Cell Lung Cancer (ES-SCLC) with response to systemic chemotherapy, based on two randomized clinical trials, which varied in patient selection and radiation therapy doses administered. The current pattern of practice among US radiation oncologists is unknown. Materials and methods We have surveyed practicing US radiation oncologist via a short online questionnaire. Respondents’ characteristics and their self-rated knowledge base were analyzed for association with their treatment recommendations. Results We received 473 responses from practicing US radiation oncologists. Over half of respondents were practicing for over 10 years after completing residency training and 70% treated more than 10 lung cancer patients per year. 96% of respondents recommend TCRT for patients with ES-SCLC after systemic chemotherapy. Patient selection and radiation therapy doses vary greatly. High self-rated knowledge of individual clinical trials is associated with lower TCRT recommended doses. Patients treated at academic centers are less likely to receive TCRT than patients treated in private clinics (p = 0.0101). Conclusion Our analysis revealed that among the respondents, there was a very high adherence to current NCCN guidelines, which recommend TCRT for ES-SCLC patients with clinical response to systemic chemotherapy. The great variability in patient selection and radiation therapy doses is concerning and calls for future clinical trials to standardize treatment approaches and improve treatment outcomes among patients with ES-SCLC. Until such data exists and in light of poor long-term survival of patients with ES-SCLC, the shorter and less toxic regimen of 30 Gy in 10 fractions should be used as the standard of care and the more aggressive regimens studied on clinical protocols.

Original languageEnglish (US)
Pages (from-to)85-89
Number of pages5
JournalLung Cancer
Volume100
DOIs
StatePublished - Oct 1 2016

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Small Cell Lung Carcinoma
Patient Care
Radiotherapy
Thorax
Patient Selection
Drug Therapy
Clinical Trials
Guidelines
Knowledge Bases
Surveys and Questionnaires
Radiation Oncologists
Poisons
Standard of Care
Internship and Residency
Clinical Protocols
Lung Neoplasms
Neoplasms
Randomized Controlled Trials
Survival
Therapeutics

Keywords

  • Extended-stage small cell lung cancer
  • Practice patterns
  • Survey
  • Thoracic radiation therapy

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

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title = "Current patterns of care for patients with extensive stage small cell lung cancer: Survey of US radiation oncologists on their recommendations regarding thoracic consolidation radiotherapy",
abstract = "Objectives Current National Comprehensive Cancer Network (NCCN) guidelines recommend thoracic consolidation radiation therapy (TCRT) for patients with Extensive Stage Small Cell Lung Cancer (ES-SCLC) with response to systemic chemotherapy, based on two randomized clinical trials, which varied in patient selection and radiation therapy doses administered. The current pattern of practice among US radiation oncologists is unknown. Materials and methods We have surveyed practicing US radiation oncologist via a short online questionnaire. Respondents’ characteristics and their self-rated knowledge base were analyzed for association with their treatment recommendations. Results We received 473 responses from practicing US radiation oncologists. Over half of respondents were practicing for over 10 years after completing residency training and 70{\%} treated more than 10 lung cancer patients per year. 96{\%} of respondents recommend TCRT for patients with ES-SCLC after systemic chemotherapy. Patient selection and radiation therapy doses vary greatly. High self-rated knowledge of individual clinical trials is associated with lower TCRT recommended doses. Patients treated at academic centers are less likely to receive TCRT than patients treated in private clinics (p = 0.0101). Conclusion Our analysis revealed that among the respondents, there was a very high adherence to current NCCN guidelines, which recommend TCRT for ES-SCLC patients with clinical response to systemic chemotherapy. The great variability in patient selection and radiation therapy doses is concerning and calls for future clinical trials to standardize treatment approaches and improve treatment outcomes among patients with ES-SCLC. Until such data exists and in light of poor long-term survival of patients with ES-SCLC, the shorter and less toxic regimen of 30 Gy in 10 fractions should be used as the standard of care and the more aggressive regimens studied on clinical protocols.",
keywords = "Extended-stage small cell lung cancer, Practice patterns, Survey, Thoracic radiation therapy",
author = "Timur Mitin and Aditya Jain and Catherine Degnin and Yiyi Chen and Mark Henderson and Charles Thomas",
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doi = "10.1016/j.lungcan.2016.08.005",
language = "English (US)",
volume = "100",
pages = "85--89",
journal = "Lung Cancer",
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T1 - Current patterns of care for patients with extensive stage small cell lung cancer

T2 - Survey of US radiation oncologists on their recommendations regarding thoracic consolidation radiotherapy

AU - Mitin, Timur

AU - Jain, Aditya

AU - Degnin, Catherine

AU - Chen, Yiyi

AU - Henderson, Mark

AU - Thomas, Charles

PY - 2016/10/1

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N2 - Objectives Current National Comprehensive Cancer Network (NCCN) guidelines recommend thoracic consolidation radiation therapy (TCRT) for patients with Extensive Stage Small Cell Lung Cancer (ES-SCLC) with response to systemic chemotherapy, based on two randomized clinical trials, which varied in patient selection and radiation therapy doses administered. The current pattern of practice among US radiation oncologists is unknown. Materials and methods We have surveyed practicing US radiation oncologist via a short online questionnaire. Respondents’ characteristics and their self-rated knowledge base were analyzed for association with their treatment recommendations. Results We received 473 responses from practicing US radiation oncologists. Over half of respondents were practicing for over 10 years after completing residency training and 70% treated more than 10 lung cancer patients per year. 96% of respondents recommend TCRT for patients with ES-SCLC after systemic chemotherapy. Patient selection and radiation therapy doses vary greatly. High self-rated knowledge of individual clinical trials is associated with lower TCRT recommended doses. Patients treated at academic centers are less likely to receive TCRT than patients treated in private clinics (p = 0.0101). Conclusion Our analysis revealed that among the respondents, there was a very high adherence to current NCCN guidelines, which recommend TCRT for ES-SCLC patients with clinical response to systemic chemotherapy. The great variability in patient selection and radiation therapy doses is concerning and calls for future clinical trials to standardize treatment approaches and improve treatment outcomes among patients with ES-SCLC. Until such data exists and in light of poor long-term survival of patients with ES-SCLC, the shorter and less toxic regimen of 30 Gy in 10 fractions should be used as the standard of care and the more aggressive regimens studied on clinical protocols.

AB - Objectives Current National Comprehensive Cancer Network (NCCN) guidelines recommend thoracic consolidation radiation therapy (TCRT) for patients with Extensive Stage Small Cell Lung Cancer (ES-SCLC) with response to systemic chemotherapy, based on two randomized clinical trials, which varied in patient selection and radiation therapy doses administered. The current pattern of practice among US radiation oncologists is unknown. Materials and methods We have surveyed practicing US radiation oncologist via a short online questionnaire. Respondents’ characteristics and their self-rated knowledge base were analyzed for association with their treatment recommendations. Results We received 473 responses from practicing US radiation oncologists. Over half of respondents were practicing for over 10 years after completing residency training and 70% treated more than 10 lung cancer patients per year. 96% of respondents recommend TCRT for patients with ES-SCLC after systemic chemotherapy. Patient selection and radiation therapy doses vary greatly. High self-rated knowledge of individual clinical trials is associated with lower TCRT recommended doses. Patients treated at academic centers are less likely to receive TCRT than patients treated in private clinics (p = 0.0101). Conclusion Our analysis revealed that among the respondents, there was a very high adherence to current NCCN guidelines, which recommend TCRT for ES-SCLC patients with clinical response to systemic chemotherapy. The great variability in patient selection and radiation therapy doses is concerning and calls for future clinical trials to standardize treatment approaches and improve treatment outcomes among patients with ES-SCLC. Until such data exists and in light of poor long-term survival of patients with ES-SCLC, the shorter and less toxic regimen of 30 Gy in 10 fractions should be used as the standard of care and the more aggressive regimens studied on clinical protocols.

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