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Patterns of practice in radiation therapy for non-small cell lung cancer among members of the American Society for Radiation Oncology
Affiliation:1. Department of Radiation Oncology, University of Michigan, Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan;2. Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama;3. Department of Radiation Oncology, University of Colorado at Denver, Denver, Colorado;4. Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas;5. Radiation Oncology, Princess Margaret Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada;6. Radiation Oncology, SSM Cancer Care, St Louis, Missouri;7. Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California;8. Department of Radiation Oncology, Henry Ford Health System, Detroit, Michigan;1. Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA;2. American College of Radiology, Philadelphia, PA;3. University of Texas MD Anderson Cancer Center, Houston, TX;4. Medical College of Wisconsin, Milwaukee, WI;5. Department of Radiation Oncology, Henry Ford Hospital, Dearborn, MI;1. Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California;2. Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California;3. Institute for Stem Cell Biology & Regenerative Medicine, Stanford University School of Medicine, Stanford, California
Abstract:PurposeTo better define patterns of practice for patients with non-small cell lung cancer (NSCLC) in the United States.Methods and MaterialsA survey of 36 questions was designed to collect information regarding practice patterns of radiation oncologists for the management of patients with NSCLC. All American Society for Radiation Oncology members were invited to respond.ResultsFour hundred twenty-four responses from radiation oncologists in the United States were received. The response rate for the survey was approximately 20%. Substantial discrepancies were seen in the use of stereotactic body radiation therapy (SBRT) for patients with peripherally and centrally located early-stage tumors and in the recommended SBRT dose. There was a near consensus opinion regarding the use of concurrent chemotherapy and the radiation dose for patients with inoperable stage II and III NSCLC with a good performance status; however, in patients with a poor performance status or in patients with stage IV disease treatment recommendations differed remarkably. Additionally, the use of elective nodal irradiation and the assessment of tumor motion during simulation were highly variable. Thoracic radiation oncologists were more likely to prescribe higher doses, omit elective nodal irradiation, and use advanced technologies (P < .001).ConclusionsSubstantial variations were seen in the management of patients with stage I and IV NSCLC in addition to the incorporation of new technology. This information can be used to help design meaningful clinical trials.
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