title: Patterns of practice in radiation therapy for non-small cell lung cancer among members of the American Society for Radiation Oncology.
abstract: OBJECTIVE
  To better define patterns of practice for patients with non-small cell lung cancer (NSCLC) in the United States.
  
  
  METHODS
  A survey of 36 questions was designed to collect information regarding practice patterns of radiation oncologists for the management of patients with NSCLC. All American Society for Radiation Oncology members were invited to respond.
  
  
  RESULTS
  Four hundred twenty-four responses from radiation oncologists in the United States were received. The response rate for the survey was approximately 20%. Substantial discrepancies were seen in the use of stereotactic body radiation therapy (SBRT) for patients with peripherally and centrally located early-stage tumors and in the recommended SBRT dose. There was a near consensus opinion regarding the use of concurrent chemotherapy and the radiation dose for patients with inoperable stage II and III NSCLC with a good performance status; however, in patients with a poor performance status or in patients with stage IV disease treatment recommendations differed remarkably. Additionally, the use of elective nodal irradiation and the assessment of tumor motion during simulation were highly variable. Thoracic radiation oncologists were more likely to prescribe higher doses, omit elective nodal irradiation, and use advanced technologies (P < .001).
  
  
  CONCLUSIONS
  Substantial variations were seen in the management of patients with stage I and IV NSCLC in addition to the incorporation of new technology. This information can be used to help design meaningful clinical trials.
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan. Electronic address: fengkong@med.umich.edu.
authors.forename: Feng-Ming Spring
authors.initials: FS
authors.lastname: Kong
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan. Electronic address: kcuneo@umich.edu.
authors.forename: Kyle C
authors.initials: KC
authors.lastname: Cuneo
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: James A
authors.initials: JA
authors.lastname: Bonner
authors.affiliation: Department of Radiation Oncology, University of Colorado at Denver, Denver, Colorado.
authors.forename: Laurie E
authors.initials: LE
authors.lastname: Gaspar
authors.affiliation: Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Komaki
authors.affiliation: Radiation Oncology, Princess Margaret Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Alexander
authors.initials: A
authors.lastname: Sun
authors.affiliation: Radiation Oncology, SSM Cancer Care, St Louis, Missouri.
authors.forename: David E
authors.initials: DE
authors.lastname: Morris
authors.affiliation: Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Howard M
authors.initials: HM
authors.lastname: Sandler
authors.affiliation: Department of Radiation Oncology, Henry Ford Health System, Detroit, Michigan.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Movsas
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy*; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy*; D010818:Practice Patterns, Physicians'; D011878:Radiotherapy / Q000706:statistics & numerical data; D012955:Societies, Medical; D011795:Surveys and Questionnaires