TY - JOUR
T1 - Patterns of Care and Barriers to Utilization of Definitive Concurrent Chemoradiation Therapy for Stage III Non-Small Cell Lung Cancer in Russia
AU - Dengina, Natalia
AU - Chernykh, Marina
AU - Degnin, Catherine
AU - Chen, Yiyi
AU - Tsimafeyeu, Ilya
AU - Karaseva, Vera V.
AU - Tjulandin, Sergei
AU - Laktionov, Konstantin
AU - Thomas, Charles R.
AU - Mitin, Timur
N1 - Publisher Copyright:
© 2021, American Association for Cancer Education.
PY - 2022/10
Y1 - 2022/10
N2 - Background: Definitive concurrent chemoradiation (cCRT) is offered to only 3% of Russian patients with stage III NSCLC. To determine the patterns of care and barriers to cCRT utilization in Russia, we conducted a survey of practicing radiation oncologists (ROs). Methods: Electronic IRB-approved survey containing 15 questions was distributed to Russian ROs. Fisher’s exact test or Cochran-Armitage test of trend was used to assess the associations between clinical experience, practice type, and patterns of care. Results: We analyzed 58 questionnaires completed by ROs—16 respondents from tertiary referral hospitals, and 42 from community or private centers. A total of 88% of respondents formulate treatment recommendations in multi-disciplinary tumor boards. For unresectable stage III NSCLC, the most common recommendation is sequential CRT (50%), followed by concurrent CRT (40%), with an observed higher utilization of cCRT in tertiary centers (9/16, 56% vs 14/42, 33%). Of the respondents, 31% do not offer cCRT to their pts. Among reasons for avoiding cCRT are (1) poor performance of pts (76%); (2) high toxicity of therapy (55%); (3) lack of consensus among tumor board members (33%); and (4) preference for sequential CRT (31%). Only 3% do not irradiate elective LNs. Eighty-six percent of respondents counsel their NSCLC pts regarding smoking cessation. Conclusions: Despite level 1 evidence, cCRT is rarely used in Russia for pts with locally advanced NSCLC, and preference for sequential therapy and concerns over high toxicity are the most common barriers. Education of Russian ROs may increase cCRT utilization, leading to improved survival, notably in the era of maintenance immunotherapy.
AB - Background: Definitive concurrent chemoradiation (cCRT) is offered to only 3% of Russian patients with stage III NSCLC. To determine the patterns of care and barriers to cCRT utilization in Russia, we conducted a survey of practicing radiation oncologists (ROs). Methods: Electronic IRB-approved survey containing 15 questions was distributed to Russian ROs. Fisher’s exact test or Cochran-Armitage test of trend was used to assess the associations between clinical experience, practice type, and patterns of care. Results: We analyzed 58 questionnaires completed by ROs—16 respondents from tertiary referral hospitals, and 42 from community or private centers. A total of 88% of respondents formulate treatment recommendations in multi-disciplinary tumor boards. For unresectable stage III NSCLC, the most common recommendation is sequential CRT (50%), followed by concurrent CRT (40%), with an observed higher utilization of cCRT in tertiary centers (9/16, 56% vs 14/42, 33%). Of the respondents, 31% do not offer cCRT to their pts. Among reasons for avoiding cCRT are (1) poor performance of pts (76%); (2) high toxicity of therapy (55%); (3) lack of consensus among tumor board members (33%); and (4) preference for sequential CRT (31%). Only 3% do not irradiate elective LNs. Eighty-six percent of respondents counsel their NSCLC pts regarding smoking cessation. Conclusions: Despite level 1 evidence, cCRT is rarely used in Russia for pts with locally advanced NSCLC, and preference for sequential therapy and concerns over high toxicity are the most common barriers. Education of Russian ROs may increase cCRT utilization, leading to improved survival, notably in the era of maintenance immunotherapy.
KW - Chemoradiation therapy
KW - Non-small cell lung cancer
KW - Russia
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U2 - 10.1007/s13187-021-01966-8
DO - 10.1007/s13187-021-01966-8
M3 - Article
C2 - 33533013
AN - SCOPUS:85100431773
SN - 0885-8195
VL - 37
SP - 1378
EP - 1384
JO - Journal of Cancer Education
JF - Journal of Cancer Education
IS - 5
ER -