title: Treatment decisions and survival for people with small-cell lung cancer.
abstract: BACKGROUND
  Chemotherapy improves survival for many patients with SCLC, and hence it is important to understand variations in practice and outcomes for this treatment strategy.
  
  
  METHODS
  We used the National Lung Cancer Audit and Hospital Episodes Statistics to determine the proportion of patients who received chemotherapy for SCLC, and assess the effects of patient and organisational factors on the odds of receiving chemotherapy and of completing four cycles. We calculated median survival and used Cox regression to determine factors that predicted survival.
  
  
  RESULTS
  Of 15 091 cases of SCLC, 70% received at least one cycle of chemotherapy. More deprived people were less likely to receive chemotherapy, but patients were more likely to receive chemotherapy, and to complete ≥ four cycles, if they were referred to the lung cancer team by their GP. Median survival for those treated with chemotherapy was 12.9 months for limited and 7.3 months for extensive stage disease.
  
  
  CONCLUSIONS
  The Linked NLCA and HES data provide real-life measures of survival in people treated with chemotherapy and show how this is influenced by patient and tumour characteristics. These data show the characteristics of patients who are less likely to complete a full course of treatment, an adverse predictor of survival.
authors.affiliation: 1] Nottingham Respiratory Research Unit, Clinical Sciences Building, University of Nottingham, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK [2] Epidemiology & Public Health, Clinical Sciences Building, University of Nottingham, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.
authors.forename: H A
authors.initials: HA
authors.lastname: Powell
authors.affiliation: Epidemiology & Public Health, Clinical Sciences Building, University of Nottingham, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.
authors.forename: L J
authors.initials: LJ
authors.lastname: Tata
authors.affiliation: Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham NG5 1PB, UK.
authors.forename: D R
authors.initials: DR
authors.lastname: Baldwin
authors.affiliation: Department of Oncology, Nottingham University Hospitals NHS Trust, Nottingham NG5 1PB, UK.
authors.forename: V A
authors.initials: VA
authors.lastname: Potter
authors.affiliation: Health and Social Care Information Centre, 1 Trevelyan Square, Boar Lane, Leeds, West Yorkshire LS1 6AE, UK.
authors.forename: R A
authors.initials: RA
authors.lastname: Stanley
authors.affiliation: Epidemiology & Public Health, Clinical Sciences Building, University of Nottingham, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.
authors.forename: A
authors.initials: A
authors.lastname: Khakwani
authors.affiliation: 1] Nottingham Respiratory Research Unit, Clinical Sciences Building, University of Nottingham, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK [2] Epidemiology & Public Health, Clinical Sciences Building, University of Nottingham, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.
authors.forename: R B
authors.initials: RB
authors.lastname: Hubbard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy* / Q000401:mortality; D013534:Survival; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents