Effect of Radiotherapy Planning Complexity on Survival of Elderly Patients With Unresected Localized Lung Cancer

Journal Article · Tue Nov 01 04:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.06.060· OSTI ID:21590430

Park, Chang H ^[1]; Bonomi, Marcelo ^[2]; Cesaretti, Jamie ^[3]; Neugut, Alfred I ^[4]

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1. Brookdale Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, NY (United States)
2. Divisions of Hematology-Oncology and Palliative Care Medicine, Mount Sinai School of Medicine, New York, NY (United States)
3. Florida Radiation Oncology Group, Baptist Cancer Institute, Jacksonville, FL (United States)
4. Department of Medicine and Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University, New York, NY (United States)

Purpose: To evaluate whether complex radiotherapy (RT) planning was associated with improved outcomes in a cohort of elderly patients with unresected Stage I-II non-small-cell lung cancer (NSCLC). Methods and Materials: Using the Surveillance, Epidemiology, and End Results registry linked to Medicare claims, we identified 1998 patients aged >65 years with histologically confirmed, unresected stage I-II NSCLC. Patients were classified into an intermediate or complex RT planning group using Medicare physician codes. To address potential selection bias, we used propensity score modeling. Survival of patients who received intermediate and complex simulation was compared using Cox regression models adjusting for propensity scores and in a stratified and matched analysis according to propensity scores. Results: Overall, 25% of patients received complex RT planning. Complex RT planning was associated with better overall (hazard ratio 0.84; 95% confidence interval, 0.75-0.95) and lung cancer-specific (hazard ratio 0.81; 95% confidence interval, 0.71-0.93) survival after controlling for propensity scores. Similarly, stratified and matched analyses showed better overall and lung cancer-specific survival of patients treated with complex RT planning. Conclusions: The use of complex RT planning is associated with improved survival among elderly patients with unresected Stage I-II NSCLC. These findings should be validated in prospective randomized controlled trials.

• OSTI ID: 21590430
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 81; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ADULTS
AGE GROUPS
AGED ADULTS
ANIMALS
BODY
DISEASES
ELDERLY PEOPLE
EPIDEMIOLOGY
HAZARDS
HUMAN POPULATIONS
LUNGS
MAMMALS
MAN
MEDICINE
MINORITY GROUPS
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
POPULATIONS
PRIMATES
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
SIMULATION
THERAPY
VERTEBRATES