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Small-cell lung cancer in England: trends in survival and chemotherapy using the National Lung Cancer Audit

Khakwani, Aamir; Rich, Anna L.; Tata, Laila J.; Powell, Helen A.; Stanley, Rosamund A.; Baldwin, David R.; Hubbard, Richard B.

Authors

Aamir Khakwani aamir.khakwani@nottingham.ac.uk

Anna L. Rich

Laila J. Tata laila.tata@nottingham.ac.uk

Helen A. Powell

Rosamund A. Stanley

David R. Baldwin

Richard B. Hubbard richard.hubbard@nottingham.ac.uk

Abstract

Background: The purpose of this study was to identify trends in survival and chemotherapy use for individuals with smallcell lung cancer (SCLC) in England using the National Lung Cancer Audit (NLCA).
Methods: We used data from the NLCA database to identify people with histologically proven SCLC from 2004–2011. We
calculated the median survival by stage and assessed whether patient characteristics changed over time. We also assessed whether the proportion of patients with records of chemotherapy and/or radiotherapy changed over time.
Results: 18,513 patients were diagnosed with SCLC in our cohort. The median survival was 6 months for all patients, 1 year for those with limited stage and 4 months for extensive stage. 69% received chemotherapy and this proportion changed very slightly over time (test for trends p = 0.055). Age and performance status of patients remained stable over the study period, but the proportion of patients staged increased (p-value,0.001), mainly because of improved data completeness. There has been an increase in the proportion of patients that had a record of receiving both chemotherapy and radiotherapy each year (from 19% to 40% in limited and from 9% to 21% in extensive stage from 2004 to 2011). Patients who received chemotherapy with radiotherapy had better survival compared with any other treatment (HR 0.24, 95% CI 0.23–0.25).
Conclusion: Since 2004, when the NLCA was established, the proportion of patients with SCLC having chemotherapy has remained static. We have found an upward trend in the proportion of patients receiving both chemotherapy and radiotherapy which corresponded to a better survival in this group, but as it only applied for a small proportion of patients, it was not enough to change the overall survival.

Journal Article Type Article
Publication Date Feb 21, 2014
Journal PLoS ONE
Electronic ISSN 1932-6203
Publisher Public Library of Science
Peer Reviewed Peer Reviewed
Volume 9
Issue 2
Article Number e89426
Institution Citation Khakwani, A., Rich, A. L., Tata, L. J., Powell, H. A., Stanley, R. A., Baldwin, D. R., & Hubbard, R. B. (2014). Small-cell lung cancer in England: trends in survival and chemotherapy using the National Lung Cancer Audit. PLoS ONE, 9(2), doi:10.1371/journal.pone.0089426
DOI https://doi.org/10.1371/journal.pone.0089426
Publisher URL http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0089426
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf




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