A population-based analysis of outcomes after radiotherapy in intensive care unit patients with lung cancer
| Autor: | Krista Bray Jenkyn, David A. Palma, Britney Allen, Alexander V. Louie, Lihua Li, George Rodrigues, Andrew Warner, Salimah Z. Shariff |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Younger age Episode of care business.industry medicine.medical_treatment Population based medicine.disease Intensive care unit law.invention Radiation therapy 03 medical and health sciences 0302 clinical medicine law 030220 oncology & carcinogenesis Internal medicine medicine Overall survival Original Article In patient 030212 general & internal medicine Lung cancer business |
| Zdroj: | Journal of Thoracic Disease. 10:1440-1448 |
| ISSN: | 2077-6624 2072-1439 |
| DOI: | 10.21037/jtd.2018.02.05 |
| Popis: | Background: As the value of radiotherapy (RT) in intensive care unit (ICU) patients with lung cancer is of uncertain efficacy, we evaluated characteristics, outcomes and RT utilization for such patients in Ontario, Canada. Methods: Multiple administrative databases were linked deterministically using unique encoded identifiers to identify eligible patients between April 1, 2007, and March 31, 2014. Differences in patient, treatment, institution and tumor characteristics between RT and non-RT groups at the level of episode of care were compared. Overall survival (OS) was evaluated using the Kaplan-Meier method, with differences compared using the log-rank test. Univariable and multivariable Cox proportional hazard modeling were performed to assess the effect of RT on survival. Results: RT was delivered in 133 episodes of care to 1.0% (n=131) of the 13,739 unique patients with lung cancer. RT delivery was associated with younger age (median 65 vs . 68, P vs . 38.2%, P vs . 0 days, P vs . 9.7%) or the emergency room (ER) (28.6% vs . 21.9%) was more likely in the RT group (P vs . 42.4%). RT was associated with inferior 1-year OS on unadjusted modeling (HR =1.99, P Conclusions: Major geographic disparities exist in the rare use of RT for lung cancer in the ICU. A significant proportion of patients receiving RT achieve discharge and a minority achieve prolonged survival, suggesting that RT use may not be futile. |
| Databáze: | OpenAIRE |
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