Findings from a recent study indicate that treatment at high-volume facilities is associated with improved overall survival among stage III NSCLC patients receiving definitive CCRT, independent of academic affiliation. The study was recently published in the Journal of Thoracic Oncology, the official journal of the International Association for the Study of Lung Cancer.
In their study titled “Patients selected for definitive concurrent chemoradiation at high-volume facilities achieve improved survival in stage III non-small cell lung cancer,” researchers from the Yale University School of Medicine analyzed data from the National Cancer Database (NCDB), a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society, for patients who were treated with concurrent chemoradiation (CCRT) for stage III NSCLC diagnosed and clinically staged between 2004 and 2006. They sought to determine if there was a relationship between treatments at facilities with expertise in treating a large number of CCRT cases and improved overall survival, as well as determine if any patient characteristics were associated with treatment at high-volume facilities.
From a total of 10,073 NSCLC patients analyzed, the researchers found that 12.0% were treated at high-volume facilities. Results revealed that these patients were more likely to score high in the Charlson/Deyo comorbidity score, to be in a more advanced stage of their cancer, to receive higher doses, and 3D-conformal or intensity-modulated radiotherapy. Then the researchers controlled the analysis for academic affiliation and treatment at high-volume facilities and found that these factors were related to decreased risk of death.
The researchers concluded that treatment given at high-volume facilities is strongly related with an improvement in the overall survival rate in patients with advanced NSCLC under definitive CCRT, independent of academic affiliation.
The authors indicate that “improved multidisciplinary collaboration, more tumor-site specific specialists, higher rates of protocol compliance, and the ability to provide chemotherapy and radiation therapy at the same center may be contributing to the increased survival at high-volume facilities.” Dr. Henry S. Park, senior author of the study, said in a recent news release, “further research is needed to determine whether or not centralizing chemoradiotherapy at high-volume facilities will improve lung cancer survival while reducing complications and costs.”