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Chemoradiation treatment patterns among United States Veteran Health Administration patients with unresectable stage III non-small cell lung cancer.

Publication ,  Journal Article
Hung, A; Lee, KM; Lynch, JA; Li, Y; Poonnen, P; Efimova, OV; Hintze, BJ; Buckingham, T; Yong, C; Seal, B; Kelley, MJ; Reed, SD
Published in: BMC Cancer
July 16, 2021

BACKGROUND: The Veterans Health Administration (VHA) is the largest integrated health care system in the United States (US). Among VHA patients, the rate of use of concurrent chemoradiation therapy (CCRT) among those with unresectable, stage III non-small cell lung cancer (NSCLC) is unknown. The objective was to report recent CCRT treatment patterns in VHA patients and identify characteristics associated with receipt of CCRT. METHODS: Using Department of Veteran Affairs (VA) Cancer Registry System data linked to VA electronic medical records, we determined rates of CCRT, sequential CRT (SCRT), radiation therapy (RT) only, chemotherapy (CT) only, and neither treatment. RESULTS: Among 4054 VHA patients who met study criteria, CCRT rates slightly increased from 44 to 50% between 2013 and 2017. Factors associated with decreased odds of CCRT receipt compared to any other treatment included increasing age (adjusted odds ratio [aOR] per 10 years = 0.67; 95% CI: 0.60-0.76) and Charlson-Deyo comorbidity score (aOR = 0.94; 95% CI: 0.91-0.97). White race was associated with increased odds of CCRT receipt (aOR = 1.24; 95% CI: 1.004-1.53). In a chart review sample of 200 patients, less than half (n = 85) had a documented reason for not receiving CCRT. Among these, 29% declined treatment, and 71% did not receive CCRT due to "not being a candidate" for reasons related to frailty or lung nodules being too far apart for radiation therapy. CONCLUSIONS: CCRT rates among VHA patients with unresectable, stage III NSCLC slightly increased from 2013 to 2017; however in 2017, only half were receiving CCRT. Older patients and those with multiple comorbidities were less likely to receive CCRT and even when controlling for these factors, non-white patients were less likely to receive CCRT.

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Published In

BMC Cancer

DOI

EISSN

1471-2407

Publication Date

July 16, 2021

Volume

21

Issue

1

Start / End Page

824

Location

England

Related Subject Headings

  • Veterans Health Services
  • Veterans
  • United States
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Chemoradiotherapy
 

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Hung, A., Lee, K. M., Lynch, J. A., Li, Y., Poonnen, P., Efimova, O. V., … Reed, S. D. (2021). Chemoradiation treatment patterns among United States Veteran Health Administration patients with unresectable stage III non-small cell lung cancer. BMC Cancer, 21(1), 824. https://doi.org/10.1186/s12885-021-08577-y
Hung, Anna, Kyung Min Lee, Julie A. Lynch, Yanhong Li, Pradeep Poonnen, Olga V. Efimova, Bradley J. Hintze, et al. “Chemoradiation treatment patterns among United States Veteran Health Administration patients with unresectable stage III non-small cell lung cancer.BMC Cancer 21, no. 1 (July 16, 2021): 824. https://doi.org/10.1186/s12885-021-08577-y.
Hung, Anna, et al. “Chemoradiation treatment patterns among United States Veteran Health Administration patients with unresectable stage III non-small cell lung cancer.BMC Cancer, vol. 21, no. 1, July 2021, p. 824. Pubmed, doi:10.1186/s12885-021-08577-y.
Hung A, Lee KM, Lynch JA, Li Y, Poonnen P, Efimova OV, Hintze BJ, Buckingham T, Yong C, Seal B, Kelley MJ, Reed SD. Chemoradiation treatment patterns among United States Veteran Health Administration patients with unresectable stage III non-small cell lung cancer. BMC Cancer. 2021 Jul 16;21(1):824.
Journal cover image

Published In

BMC Cancer

DOI

EISSN

1471-2407

Publication Date

July 16, 2021

Volume

21

Issue

1

Start / End Page

824

Location

England

Related Subject Headings

  • Veterans Health Services
  • Veterans
  • United States
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Chemoradiotherapy