Who are the vulnerable lung cancer patients at risk for not receiving first-line curative or palliative treatment?

Autor: Langballe R; Psychological Aspects of Cancer, the Danish Cancer Society Research Center, Copenhagen, Denmark.; Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark., Jakobsen E; Department of Thoracic surgery, Odense University Hospital, Odense C, Denmark.; The Danish Lung Cancer Registry, Odense University Hospital, Odense C, Denmark., Iachina M; Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, Odense University Hospital, Odense C, Denmark., Karlsen RV; Psychological Aspects of Cancer, the Danish Cancer Society Research Center, Copenhagen, Denmark., Ehlers JH; Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark., Svendsen MN; Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark., Bodtger U; Respiratory Research Unit PLUZ, Department of Respiratory Medicine, Zealand University Hospital Roskilde/Næstved, Næstved, Denmark.; Institute for Regional Health Research, University of Southern Denmark, Odense C, Denmark., Hilberg O; Institute for Regional Health Research, University of Southern Denmark, Odense C, Denmark.; Department of Respiratory Disease, Vejle Hospital, Vejle, Denmark., Dalton SO; Survivorship and Inequality in Cancer, the Danish Cancer Society Research Center, Copenhagen, Denmark.; Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark., Bidstrup PE; Psychological Aspects of Cancer, the Danish Cancer Society Research Center, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Acta oncologica (Stockholm, Sweden) [Acta Oncol] 2023 Oct; Vol. 62 (10), pp. 1301-1308. Date of Electronic Publication: 2023 Sep 01.
DOI: 10.1080/0284186X.2023.2252581
Abstrakt: Background: To identify non-small-cell lung cancer (NSCLC) patients in need of comprehensive support, we examined the association between patient and disease-related factors of vulnerability related to not receiving guideline-recommended treatment.
Material and Methods: We identified 14,597 non-small-cell lung cancer (NSCLC) patients with performance status <3 during 2013-2018 in the Danish Lung Cancer Registry. Multivariate logistic regression models were used to estimate Odds Ratios (ORs) and 95% confidence intervals (CIs) for receiving guideline-recommended treatment according to stage, comorbidities, age, performance status, long distance to hospital, cohabitation status, education and alcohol abuse.
Results: 21% of stage I-IIIA NSCLC patients did not receive curative treatment while 10% with stage IIIB-IV did not receive any oncological therapy. Factors associated with reduced likelihood of receiving curative treatment included: advanced stage (OR = 0.45; 95% CI = 0.42-0.49), somatic comorbidity (OR = 0.72; 95% CI = 0.63-0.83), age ≥ 80 years (OR = 0.59; 95% CI = 0.55-0.64), performance status = 2 (OR = 0.33; 95% CI = 0.28-0.39) and living alone (OR = 0.79; 95% CI = 0.69-0.90). Results were similar for stage IIIB-IV NSCLC patients, although a statistically significant association was also seen for long distances to the hospital (OR = 0.71; 95% CI = 0.58-0.86).
Conclusions: Several factors are associated with not receiving guideline-recommended NSCLC treatment with age, performance status, comorbidity and stage being most predictive of no treatment receipt. Efforts should be made to develop support for vulnerable lung cancer patients to improve adherence to optimal first-line therapy.
Databáze: MEDLINE
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