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From evidence to practice: Audit of adjuvant chemotherapy after complete resection of non‐small cell lung cancer in an Australian lung cancer center
Author(s) -
DANIELS Marissa,
NEWNHAM Genni M,
WRIGHT Gavin M
Publication year - 2005
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/j.1743-7563.2005.00020.x
Subject(s) - medicine , lung cancer , chemotherapy , referral , cancer , surgery , family medicine
Objective: To investigate patterns in the rate of referral and uptake of platinum‐based adjuvant chemotherapy following resection of non‐small cell lung cancer (NSCLC) after recent landmark evidence‐based publications. Design and setting: An audit of all patients who underwent complete resection of NSCLC by a specialist thoracic surgeon between 1 January 2002 and 31 December 2004. Results of several randomised trials of adjuvant therapy (including the largest ever multicentre trial) were reported during this period and confirmed an overall and disease‐free survival benefit. Patients: One hundred and twenty‐six adult patients who underwent complete resection of histologically confirmed NSCLC between 1 January 2002 and 31 December 2004. Main outcome measure: Percentage of patients referred, commencing and completing platinum‐based adjuvant chemotherapy between January and June 2002, July and December 2002, January and June 2003, July and December 2003, January and June 2004, and July and December 2004. Results: Of patients who underwent complete resection of NSCLC in each of the 6‐month intervals, 0.0%, 3.4%, 30.8%, 52.2%, 58.8% and 68.3% were referred for adjuvant chemotherapy, respectively. Treatment delivery rates were 0.0%, 3.4%, 7.7%, 30.4%, 29.4% and 36.8%, respectively. The most common reason for failing to receive adjuvant chemotherapy after referral was excessive risks compared with benefits of treatment as perceived by the medical oncologist and/or patient. Conclusion: Both rate of referral and utilization of platinum‐based adjuvant chemotherapy have increased with successive publications of evidence of survival benefit. Further improvements may be possible by routine referral policy, earlier timing and choice of regimen.