Five years managing metastatic non-small cell lung cancer: experience at a teaching hospital.
BACKGROUND
The management of patients with metastatic non-small cell lung cancer (NSCLC) is complex. Some studies have demonstrated that the care of patients with NSCLC may be suboptimal.


OBJECTIVE
To review the management of patients with metastatic NSCLC treated at a single teaching hospital over a 5-year period.


METHODS
All patients with metastatic NSCLC treated at a single teaching hospital over a 5-year period (1998-2002) were identified. Data were collected by a retrospective record review.


RESULTS
Of 343 patients with metastatic NSCLC, 157 patients were deemed eligible for this review. Thirty-one patients (19%) were admitted to the Medical Oncology Unit at initial presentation. Twenty-four patients (15%) were not referred to either the Medical Oncology Unit or the Palliative Care Unit. Forty-four patients (28%) received chemotherapy, six of whom (14%) were enrolled onto a clinical trial. Six separate chemotherapy regimens were used. The median survival was 5 months and the 1-year survival rate was 19.8%.


CONCLUSIONS
The present audit demonstrates some shortfalls in the optimal clinical care of patients with metastatic NSCLC at a large teaching hospital. The main selection criteria of consideration for chemotherapy are age, performance status and presence of symptoms. A subset of patients was not referred to either the Medical Oncology Unit or the Palliative Care Unit and consistency in the choice of chemotherapy was lacking. Survival data and the rate of patients entered onto clinical trials are acceptable; however, further improvements can be made by the institution of multidisciplinary clinics and the education of referring clinicians.
Department of Clinical Haematology and Medical Oncology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
S
S
Wong
M A
MA
Rosenthal
R
R
deBoer
M D
MD
Green
R M
RM
Fox
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000556:secondary* / Q000628:therapy*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D012189:Retrospective Studies; D016019:Survival Analysis
D000970:Antineoplastic Agents