title: Patient-provider delays in superior vena caval obstruction of lung cancer and outcomes.
abstract: This retrospective study investigates the types of delay in the initiation of palliative thoracic radiotherapy for superior vena caval obstruction (SVCO) of lung cancer (LCa) and the effect of treatment delay on patient outcomes. Treatment delays were categorized as patient delay (duration of symptoms), in-hospital delay, and professional delay and were determined in 42 people treated by radiation for palliation of the complicated neoplastic condition between 1981 and 2009. The median period of patient delay was 26.2 days, in-hospital delay was 3.5 days, and professional delay was 1.5 days. The majority (80%) of these individuals were uninsured or underinsured, and 69% presented with locally advanced LCa. The overall response rate was 84%, and the 1-year survival rate was 24%. Despite the longest patient-related delay, symptomatic individuals overall derived palliation from conventional treatment. Improved efforts toward early diagnosis and treatment of patients with SVCO-LCa need to be continued.
authors.affiliation: 1Division of Therapeutic Radiology, Louisiana State University Health, Shreveport, LA, USA.
authors.forename: Federico L
authors.initials: FL
authors.lastname: Ampil
authors.forename: Gloria
authors.initials: G
authors.lastname: Caldito
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008175:Lung Neoplasms / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013479:Superior Vena Cava Syndrome / Q000209:etiology* / Q000401:mortality / Q000532:radiotherapy; D016019:Survival Analysis; D013997:Time Factors
keywords: lung cancer; palliative care; radiotherapy; superior vena caval obstruction