Lung cancer specialists' opinions on treatment for stage I non-small cell lung cancer

A multidisciplinary survey

Austin Lammers, Timur Mitin, Drew Moghanaki, Charles Thomas, Robert Timmerman, Sara E. Golden, Sujata Thakurta, Rafal Dziadziuszko, Christopher G. Slatore

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: The current standard of care for surgically eligible stage I non-small cell lung cancer (NSCLC) is surgical resection, but emerging data suggest that stereotactic body radiation therapy (SBRT) is potentially as effective as surgery. However, specialist views of the current evidence about SBRT and how they would incorporate a randomized controlled trial (RCT) into practice is unclear. We sought to understand specialist opinions about evidence regarding treatment of stage I NSCLC and how this translates into practice and clinical trial implementation. Methods and materials: We used a 28-item, web-based survey that invited all participating providers from the American Society for Radiation Oncology, American Thoracic Society Thoracic Oncology Assembly, and the International Association for the Study of Lung Cancer to share opinions regarding practice beliefs, treatment of stage I NSCLC, and a clinical trial scenario. Results: A total of 959 surveys were completed; 64% were from radiation oncologists (ROs) and 49% were from outside the United States. The majority of ROs (80%) reported that current evidence indicates that SBRT has the same or a better benefit compared with surgery for surgically eligible patients with stage I NSCLC; 28% of non–radiation oncologists (NROs) indicated the same (P <.01). Almost all ROs (94%), compared with 62% of NROs, would permit surgically eligible patients to enroll in an RCT of SBRT versus surgery (P <.01). Most ROs (82%) and NROs (87%) believed that changing practice in thoracic surgery would be somewhat difficult, very difficult, or impossible (P =.066) even if an RCT showed better survival with SBRT. Conclusions: NROs believe that SBRT is much less effective than surgery, contrary to ROs, who believe that they are similar. Most would support an RCT, but NROs would do so less. Changes in surgical practice may be challenging even if an RCT shows better mortality and quality of life with SBRT. These results are helpful in the creation and dissemination of RCTs that are designed to understand this question.

Original languageEnglish (US)
Pages (from-to)125-129
Number of pages5
JournalAdvances in Radiation Oncology
Volume3
Issue number2
DOIs
StatePublished - Apr 1 2018

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Non-Small Cell Lung Carcinoma
Lung Neoplasms
Radiotherapy
Randomized Controlled Trials
Therapeutics
Clinical Trials
Radiation Oncology
Standard of Care
Surveys and Questionnaires
Thoracic Surgery
Thorax
Quality of Life
Oncologists
Radiation Oncologists
Survival
Mortality

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Lung cancer specialists' opinions on treatment for stage I non-small cell lung cancer : A multidisciplinary survey. / Lammers, Austin; Mitin, Timur; Moghanaki, Drew; Thomas, Charles; Timmerman, Robert; Golden, Sara E.; Thakurta, Sujata; Dziadziuszko, Rafal; Slatore, Christopher G.

In: Advances in Radiation Oncology, Vol. 3, No. 2, 01.04.2018, p. 125-129.

Research output: Contribution to journalArticle

Lammers, Austin ; Mitin, Timur ; Moghanaki, Drew ; Thomas, Charles ; Timmerman, Robert ; Golden, Sara E. ; Thakurta, Sujata ; Dziadziuszko, Rafal ; Slatore, Christopher G. / Lung cancer specialists' opinions on treatment for stage I non-small cell lung cancer : A multidisciplinary survey. In: Advances in Radiation Oncology. 2018 ; Vol. 3, No. 2. pp. 125-129.
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abstract = "Purpose: The current standard of care for surgically eligible stage I non-small cell lung cancer (NSCLC) is surgical resection, but emerging data suggest that stereotactic body radiation therapy (SBRT) is potentially as effective as surgery. However, specialist views of the current evidence about SBRT and how they would incorporate a randomized controlled trial (RCT) into practice is unclear. We sought to understand specialist opinions about evidence regarding treatment of stage I NSCLC and how this translates into practice and clinical trial implementation. Methods and materials: We used a 28-item, web-based survey that invited all participating providers from the American Society for Radiation Oncology, American Thoracic Society Thoracic Oncology Assembly, and the International Association for the Study of Lung Cancer to share opinions regarding practice beliefs, treatment of stage I NSCLC, and a clinical trial scenario. Results: A total of 959 surveys were completed; 64{\%} were from radiation oncologists (ROs) and 49{\%} were from outside the United States. The majority of ROs (80{\%}) reported that current evidence indicates that SBRT has the same or a better benefit compared with surgery for surgically eligible patients with stage I NSCLC; 28{\%} of non–radiation oncologists (NROs) indicated the same (P <.01). Almost all ROs (94{\%}), compared with 62{\%} of NROs, would permit surgically eligible patients to enroll in an RCT of SBRT versus surgery (P <.01). Most ROs (82{\%}) and NROs (87{\%}) believed that changing practice in thoracic surgery would be somewhat difficult, very difficult, or impossible (P =.066) even if an RCT showed better survival with SBRT. Conclusions: NROs believe that SBRT is much less effective than surgery, contrary to ROs, who believe that they are similar. Most would support an RCT, but NROs would do so less. Changes in surgical practice may be challenging even if an RCT shows better mortality and quality of life with SBRT. These results are helpful in the creation and dissemination of RCTs that are designed to understand this question.",
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AU - Moghanaki, Drew

AU - Thomas, Charles

AU - Timmerman, Robert

AU - Golden, Sara E.

AU - Thakurta, Sujata

AU - Dziadziuszko, Rafal

AU - Slatore, Christopher G.

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