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.

Abstract

Background
The purpose of this study was to identify trends in survival and chemotherapy use for individuals with small-cell 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.

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), Article e89426. https://doi.org/10.1371/journal.pone.0089426

• Journal Article Type: Article
• Acceptance Date: Jan 20, 2014
• Online Publication Date: Feb 21, 2014
• Publication Date: Feb 21, 2014
• Deposit Date: Jun 10, 2016
• Publicly Available Date: Jun 10, 2016
• Journal: PLoS ONE
• Electronic ISSN: 1932-6203
• Publisher: Public Library of Science
• Peer Reviewed: Peer Reviewed
• Volume: 9
• Issue: 2
• Article Number: e89426
• DOI: https://doi.org/10.1371/journal.pone.0089426
• Public URL: https://nottingham-repository.worktribe.com/output/722929
• Publisher URL: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0089426
• Contract Date: Jun 10, 2016