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New lung cancer research finds half of advanced lung cancer patients receive chemotherapy
By Dross at 2010-10-01 21:48
New lung cancer research finds half of advanced lung cancer patients receive chemotherapy

For the first time to date, research published in the October edition of the Journal of Thoracic Oncology (JTO) sought to determine the use of chemotherapyterm in a contemporary, diverse non-small cell lung cancer (NSCLC) population encompassing all patient ages. Prior population-based studies have shown that only 20 to 30 percent of advanced lung cancer patients receive chemotherapy treatment. These studies have previously relied on the Medicare-linked Surveillance, Epidemiology, and End Results (SEER) database, thus excluding the 30 to 35 percent of lung cancer patients younger than 65 years of age.

Researchers performed a retrospective analysis of patients diagnosed with stage IV NSCLC from 2000 to 2007 at the University of Texas Southwestern Medical Center in Dallas, Texas, and Parkland Health and Hospital System, the safety net hospital for Dallas County. Overall, the findings indicate that for patients with advanced non-small cell lung cancer (NSCLC), chemotherapy was administered to approximately half of all patients—more than twice the rate reported in some earlier studies. In all, 718 patients met criteria, of whom 353 received chemotherapy (49 percent). Age and insurance type were associated with treatment with chemotherapy; specifically, young patients and those with private health insurance were more likely to receive chemotherapy. Furthermore, median survival for the group which received chemotherapy was 9.2 months, compared with 2.3 months for untreated patients.

"Most of the SEER studies reported data from the early 1990s. Over the past 10 years, advances in diagnosis, treatment, and supportive care may have expanded the patient population considered for cancer therapy," explains senior investigator David E. Gerber, MD, of the Harold C. Simmons Cancer Center at the University of Texas Southwestern Medical Center. "Furthermore, physicians may not be aware of the growing evidence in support of chemotherapy for advanced NSCLC. It is hoped that future developments in this field increase not only treatment efficacy but also the proportion of patients able to benefit from them."



2 comments | 1905 reads

by gdpawel on Sat, 2010-10-02 20:22
And add to that, the June issue of Oncology News International (June 2010, V 19, No 6) quotes a Duke University study of the use of high-tech cancer imaging, with one representative finding being that the average Medicare lung cancer patient receives 11 radiographs, 6 CT scans, a PET scan, and MRI, two echocardiograms, and an ultrasound, all within two years of diagnosis. A study co-author (Dr. Kevan Schulman) asks: "Are all these imaging studies essential? Are they all of value? Is the information really meaningful? What is changing as a result of all this imaging?"

For one thing, clinical trials virtually always have time to disease progression as a primary endpoint. Without the imaging studies, one can't get accurate time to progression data. So these are tests performed for the benefit of drug companies seeking new drug approval, for clinical investigators seeking contracts and publications, and for clinicians seeking an easy way to make clinical decisions (and, occasionally, seeking income enhancement).

by gdpawel on Thu, 2010-10-14 10:16
Paul Levy is President and CEO of Beth Israel Deconess Medical Center in Boston, Massachusetts. He recently blogged on The Health Care Blog that recent trends in radiology imaging portend a dramatic and rapid reduction in this segment of a hospital's business plan. There has been a large reduction in the number of some types of imaging studies in hospitals.

The Chief of Radiology at Beth Israel summarized their experience which is common to other hospitals and provides some of the reasons.

The biggest hit has been in CT scans, the modality they most depend on for revenue. They are about 10% down in CT cases from last year, due to a combination of patient and physician fears about radiation exposure, more prudent ordering of studies by physicians, leakage out of the medical center, and the introduction of physician incentive programs (to minimize the amount of imaging) by some insurers.

Also, they have not seen an upswing in ultrasound or MRI to match the CT volume drop. and by the way, this occurred while their overall patient volume increased during the same period.

The result of these trends will be to reduce the number of radiologists working in hospitals, and there will also probably result in a reduction of salaries for this physician specialty.

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