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Adoption of adjuvant chemo for early lung cancer has improved outcomes

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Since the advantage of adding chemotherapy to surgical resection of early-stage non-small-cell lung cancer was demonstrated a few years ago, the strategy has been rapidly adopted by oncologists, according to a Canadian population-based study. The result has been a substantial improvement in survival.

Dr. Christopher M. Booth, of Queen’s University Cancer Research Institute in Kingston, Ontario, and colleagues examined rates of adjuvant chemotherapy given to over 6300 patients with NSCLC in the province from 2001 to 2006.

As reported in the Journal of Clinical Oncology, online June 21, 7% of patients received adjuvant chemotherapy during the period 2001-2003, compared with 31% during 2004-2006.

Even so, adjuvant chemotherapy may still be underutilized, because there were wide variations in age groups and in different regions of Ontario, the authors note.

“As a proxy measure of adjuvant chemotherapy-related toxicity, we evaluated hospitalizations within 6 months of surgery,” the team explains. By this metric, there was no increase in side effects between the two periods.

Within 2 years of surgery, 33% fewer patients developed metastatic disease during the later period of the study compared to the earlier period.

Furthermore, “There was a substantial improvement in 4-year survival among surgically resected patients, from 52.5% (2001 to 2003) to 56.1% (2004 to 2006; p=0.001), Dr. Booth and colleagues found.

They conclude that the benefits of adjuvant chemotherapy seen in clinical trials extend to the general population, and they call for efforts to further improve the translation of clinical research findings into practice.

Reference:

http://jco.ascopubs.org/cgi/doi/10.1200/JCO.2010.28.1709

J Clin Oncol 2010;28.