title: Metastatic non-small cell lung cancer in Brazil: treatment heterogeneity in routine clinical practice.
abstract: Lung cancer is one of the main causes of cancer related deaths. Approximately three quarters of these tumors are non-small cell carcinomas. When diagnosed the majority of patients show the disease locally advanced or metastatic. The chemotherapy is the chosen therapy for patients with advanced lung cancer. The majority of published studies with chemotherapy are performed in academic centers under a strict control of research protocols.
  
  
  OBJECTIVE
  The aim of this study is to evaluate the usual management of metastatic NSCLC patients outside of a clinical trial setting in three different oncologic centers in Brazil.
  
  
  METHODS
  This is a retrospective study of patients with metastatic non-small cell lung cancer admitted for treatment in three different Cancer Centers in Brazil. 564 patients from Brazilian public heath system and private/health insurance system were considered for the present study.
  
  
  RESULTS
  Among 564 patients in this study, 335 (59.4%) received chemotherapy. For all patients, 47 different regimens of chemotherapy were identified. The median follow-up time was eight months and the overall median survival of all patient population submitted to chemotherapy was 9.7 months.
  
  
  CONCLUSIONS
  There was a great heterogeneity in the regimens of drugs to treat metastatic NSCLC patients. The overall survival was significantly better for patients treated with first line chemotherapy compared to patients that only received best supportive care. Results of prospective randomized clinical trials should be carefully analyzed before transferred to the daily clinical practice.
authors.affiliation: Instituto Paulista de Cancerologia, Department of Clinical Oncology, São Paulo, SP, Brazil. fauzianaime@yahoo.com.br
authors.forename: Fauzia F
authors.initials: FF
authors.lastname: Naime
authors.forename: Riad Naim
authors.initials: RN
authors.lastname: Younes
authors.forename: Bruno G
authors.initials: BG
authors.lastname: Kersten
authors.forename: Agnaldo
authors.initials: A
authors.lastname: Anelli
authors.forename: Carlos Augusto M
authors.initials: CA
authors.lastname: Beato
authors.forename: Rogério M
authors.initials: RM
authors.lastname: Andrade
authors.forename: Marcella P
authors.initials: MP
authors.lastname: Carrara
authors.forename: Jefferson Luiz
authors.initials: JL
authors.lastname: Gross
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D024221:Antineoplastic Protocols; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis