title: Inter- and intraobserver consistency in assessing eligibility for bevacizumab (BVZ) in non-small-cell lung cancer (NSCLC) patients with centrally located tumors.
abstract: BACKGROUND
  Bevacizumab (BVZ) combined with platinum-based therapy is registered for first-line treatment of nonsquamous non-small-cell lung cancer (NSCLC). Patients with centrally located tumors are stated ineligible for BVZ treatment. The goal of this study was to assess the consistency in evaluating eligibility of patients with central tumors for BVZ treatment.
  
  
  METHODS
  The study group was composed of 150 NSCLC patients with centrally located tumors. Eligibility for BVZ was assessed by chest computed tomography (CT) scan. Eligibility was assessed independently using CT images reviewed on workstations. Inter- and intraobserver variations on 50 randomly extracted patients were estimated through a statistical modeling (multiple correspondence analysis).
  
  
  RESULTS
  Discordance in eligibility was found for 82 patients (55%). The interobserver strength of agreement was fair to moderate (average kappa = 0.40). Contrarily, the intraobserver strength of agreement was good to very good (average kappa = 0.74). At multivariate analysis, the risk of discrepancy was essentially related to the assessment of the contact between the tumor and the vessels (odds ratio = 13.3, 95% confidence interval 2.8-62.6, P = 0.001).
  
  
  CONCLUSIONS
  The consistency in evaluating eligibility of patients with central tumors for BVZ treatment is weak. The study group indicated more stringent criteria to help physicians in taking the best treatment choice that need however to be prospectively validated.
authors.affiliation: Department of Thoracic Oncology, Université de la Méditerranée-Assistance Publique Hôpitaux de Marseille, Marseille. Electronic address: fabrice.barlesi@mail.ap-hm.fr.
authors.forename: F
authors.initials: F
authors.lastname: Barlési
authors.affiliation: Department of Radiology, Institut Gustave Roussy, Villejuif.
authors.forename: C
authors.initials: C
authors.lastname: Balleyguier
authors.affiliation: Department of Medical Oncology, Institut Gustave Roussy, Villejuif.
authors.forename: B
authors.initials: B
authors.lastname: Besse
authors.affiliation: Department of Radiology, Centre Oscar Lambret, Lille.
authors.forename: F
authors.initials: F
authors.lastname: Bonodeau
authors.affiliation: Department of Radiology, Centre François Baclesse, Caen.
authors.forename: F
authors.initials: F
authors.lastname: Brenac
authors.affiliation: Department of Radiology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux.
authors.forename: O
authors.initials: O
authors.lastname: Corneloup
authors.affiliation: Department of Medical Oncology, Centre Oscar Lambret, Lille.
authors.forename: E
authors.initials: E
authors.lastname: Dansin
authors.affiliation: Department of Radiology, Centre Hospitalier Universitaire de Grenoble, Grenoble.
authors.forename: G
authors.initials: G
authors.lastname: Ferretti
authors.affiliation: Department of Radiology, Assistance Publique Hôpitaux de Marseille, Marseille.
authors.forename: J Y
authors.initials: JY
authors.lastname: Gaubert
authors.affiliation: Department of Medical Oncology, Centre François Baclesse, Caen.
authors.forename: R
authors.initials: R
authors.lastname: Gervais
authors.affiliation: Department of Radiology, Assistance Publique Hôpitaux de Paris, Paris.
authors.forename: C
authors.initials: C
authors.lastname: Lacombe
authors.affiliation: Department of Biostatistics, Assistance Publique Hôpitaux de Marseille, Marseille.
authors.forename: A
authors.initials: A
authors.lastname: Loundou
authors.affiliation: Department of Respiratory Diseases, Centre Hospitalier Universitaire de Grenoble, Grenoble.
authors.forename: D
authors.initials: D
authors.lastname: Moro-Sibilot
authors.affiliation: Department of Medical Oncology, Institut Gustave Roussy, Villejuif.
authors.forename: D
authors.initials: D
authors.lastname: Planchard
authors.affiliation: Department of Respiratory Diseases, Centre Hospitalier Universitaire de Lille, Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Scherpereel
authors.affiliation: Department of Radiology, Assistance Publique Hôpitaux de Paris, Paris.
authors.forename: Y
authors.initials: Y
authors.lastname: Menu
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015999:Multivariate Analysis; D015588:Observer Variation; D014057:Tomography, X-Ray Computed
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab