A new analysis has revealed important gaps in the optimal care of patients with stage III non-small cell lung cancer (NSCLC) in England.
The study is the first analysis of the management and outcomes of stage III NSCLC conducted in England using National Lung Cancer Audit data and included 6276 cases of stage III NSCLC (3827 stage IIIA and 2449 stage IIIB). It found that multimodality treatment with either surgery or radical radiotherapy combined with chemotherapy was delivered to less than one-fifth of patients, even though these regimens are considered optimal.
Of 6276 cases (3827 stage IIIA and 2449 stage IIIB) documented in 2016, 17% (n=1047) were treated with radical radiotherapy, with 11% of these (n=676) also receiving chemotherapy.
Twenty per cent of patients with stage IIIA disease underwent surgery, with half of these also receiving chemotherapy, predominantly delivered in the adjuvant setting.
A total of 2148 (34%) patients received palliative-intent treatment and 2265 (36%) received no active anti-cancer treatment.
One-year survival was 32.9% (37.4% for stage IIIA), with the highest survival seen in patients who received chemotherapy and surgery.
The overall, and stage IIIA-specific, curative-intent treatment rates reported in the current study are the lowest of all published studies. Although surgical resection rates were comparable, less than one-fifth of patients received radical radiotherapy as part of their treatment compared with about half of patients in Australia, the US, Belgium, and the Netherlands.