For the first time to date, research published in the October edition of the Journal of Thoracic Oncology (JTO) sought to determine the use of chemotherapy in a contemporary, diverse non-small cell lung cancer (NSCLC) population encompassing all patient ages. Prior population-based studies have shown that only 20 to 30 percent of advanced lung cancer patients receive chemotherapy treatment. These studies have previously relied on the Medicare-linked Surveillance, Epidemiology, and End Results (SEER) database, thus excluding the 30 to 35 percent of lung cancer patients younger than 65 years of age.
Researchers performed a retrospective analysis of patients diagnosed with stage IV NSCLC from 2000 to 2007 at the University of Texas Southwestern Medical Center in Dallas, Texas, and Parkland Health and Hospital System, the safety net hospital for Dallas County. Overall, the findings indicate that for patients with advanced non-small cell lung cancer (NSCLC), chemotherapy was administered to approximately half of all patients—more than twice the rate reported in some earlier studies. In all, 718 patients met criteria, of whom 353 received chemotherapy (49 percent). Age and insurance type were associated with treatment with chemotherapy; specifically, young patients and those with private health insurance were more likely to receive chemotherapy. Furthermore, median survival for the group which received chemotherapy was 9.2 months, compared with 2.3 months for untreated patients.
"Most of the SEER studies reported data from the early 1990s. Over the past 10 years, advances in diagnosis, treatment, and supportive care may have expanded the patient population considered for cancer therapy," explains senior investigator David E. Gerber, MD, of the Harold C. Simmons Cancer Center at the University of Texas Southwestern Medical Center. "Furthermore, physicians may not be aware of the growing evidence in support of chemotherapy for advanced NSCLC. It is hoped that future developments in this field increase not only treatment efficacy but also the proportion of patients able to benefit from them."
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