Barriers to Combined-Modality Therapy for Limited-Stage Small Cell Lung Cancer

JAMA Oncology
Todd A PezziStephen G Chun

Abstract

Combined-modality therapy with chemotherapy and radiation therapy plays a crucial role in the upfront treatment of patients with limited-stage small cell lung cancer (SCLC), but there may be barriers to utilization in the United States. To estimate utilization rates and factors associated with chemotherapy and radiation therapy delivery for limited-stage SCLC using the National Cancer Database. Analysis of initial management of all limited-stage SCLC cases from 2004 through 2013 in the National Cancer Database. Utilization rates of chemotherapy and radiation therapy at time of initial treatment. Multivariable analysis identified independent clinical and socioeconomic factors associated with utilization and overall survival. A total of 70 247 cases met inclusion criteria (55.3% female; median age, 68 y [range, 19-90 y]). Initial treatment was 55.5% chemotherapy and radiation therapy, 20.5% chemotherapy alone, 3.5% radiation therapy alone, and 20.0% neither (0.5% not reported). Median survival was 18.2 (95% CI, 17.9-18.4), 10.5 (95% CI, 10.3-10.7), 8.3 (95% CI, 7.7-8.8), and 3.7 (95% CI, 3.5-3.8) months, respectively. Being uninsured was associated with a lower likelihood of both chemotherapy (odds ratio [OR], 0.65; 95% CI, 0.56-...Continue Reading

References

Dec 3, 1992·The New England Journal of Medicine·J P PignonB Lebeau
Apr 9, 1987·The New England Journal of Medicine·M C PerryC Faulkner
Sep 12, 2001·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·C R ThomasD R Gandara
Sep 18, 2002·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·Patrick MickeRoland Buhl
May 18, 2004·International Journal of Radiation Oncology, Biology, Physics·Jeffrey A BogartUNKNOWN Cancer and Leukemia Group B study 39808
Mar 1, 2006·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Dirk De RuysscherPhilippe Lambin
Apr 18, 2013·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J-M SunK Park
Oct 21, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Christopher D CorsoRoy H Decker
Feb 13, 2016·Journal of Oncology Practice·Daniel AlmquistApar Kishor Ganti

❮ Previous
Next ❯

Citations

Jun 21, 2019·JAMA Oncology·Stephen G ChunJeffrey A Bogart
Jun 6, 2020·Clinical & Experimental Metastasis·Sumanth P ReddyEdward Pan
May 13, 2020·Cancer Causes & Control : CCC·Meifang ZhangLanjing Zhang
Mar 8, 2019·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Frances B MaguireKenneth W Kizer
Nov 10, 2020·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Stephen G ChunJoe Y Chang

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.