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Lung cancer specialists' opinions on treatment for stage I non-small cell lung cancer: A multidisciplinary survey
PURPOSE: The current standard of care for surgically eligible stage I non-small cell lung cancer (NSCLC) is surgical resection, but emerging data suggest that stereotactic body radiation therapy (SBRT) is potentially as effective as surgery. However, specialist views of the current evidence about SB...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6000198/ https://www.ncbi.nlm.nih.gov/pubmed/29904736 http://dx.doi.org/10.1016/j.adro.2018.01.001 |
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author | Lammers, Austin Mitin, Timur Moghanaki, Drew Thomas, Charles R. Timmerman, Robert Golden, Sara E. Thakurta, Sujata Dziadziuszko, Rafal Slatore, Christopher G. |
author_facet | Lammers, Austin Mitin, Timur Moghanaki, Drew Thomas, Charles R. Timmerman, Robert Golden, Sara E. Thakurta, Sujata Dziadziuszko, Rafal Slatore, Christopher G. |
author_sort | Lammers, Austin |
collection | PubMed |
description | PURPOSE: The current standard of care for surgically eligible stage I non-small cell lung cancer (NSCLC) is surgical resection, but emerging data suggest that stereotactic body radiation therapy (SBRT) is potentially as effective as surgery. However, specialist views of the current evidence about SBRT and how they would incorporate a randomized controlled trial (RCT) into practice is unclear. We sought to understand specialist opinions about evidence regarding treatment of stage I NSCLC and how this translates into practice and clinical trial implementation. METHODS AND MATERIALS: We used a 28-item, web-based survey that invited all participating providers from the American Society for Radiation Oncology, American Thoracic Society Thoracic Oncology Assembly, and the International Association for the Study of Lung Cancer to share opinions regarding practice beliefs, treatment of stage I NSCLC, and a clinical trial scenario. RESULTS: A total of 959 surveys were completed; 64% were from radiation oncologists (ROs) and 49% were from outside the United States. The majority of ROs (80%) reported that current evidence indicates that SBRT has the same or a better benefit compared with surgery for surgically eligible patients with stage I NSCLC; 28% of non–radiation oncologists (NROs) indicated the same (P < .01). Almost all ROs (94%), compared with 62% of NROs, would permit surgically eligible patients to enroll in an RCT of SBRT versus surgery (P < .01). Most ROs (82%) and NROs (87%) believed that changing practice in thoracic surgery would be somewhat difficult, very difficult, or impossible (P = .066) even if an RCT showed better survival with SBRT. CONCLUSIONS: NROs believe that SBRT is much less effective than surgery, contrary to ROs, who believe that they are similar. Most would support an RCT, but NROs would do so less. Changes in surgical practice may be challenging even if an RCT shows better mortality and quality of life with SBRT. These results are helpful in the creation and dissemination of RCTs that are designed to understand this question. |
format | Online Article Text |
id | pubmed-6000198 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-60001982018-06-14 Lung cancer specialists' opinions on treatment for stage I non-small cell lung cancer: A multidisciplinary survey Lammers, Austin Mitin, Timur Moghanaki, Drew Thomas, Charles R. Timmerman, Robert Golden, Sara E. Thakurta, Sujata Dziadziuszko, Rafal Slatore, Christopher G. Adv Radiat Oncol Lung Cancer PURPOSE: The current standard of care for surgically eligible stage I non-small cell lung cancer (NSCLC) is surgical resection, but emerging data suggest that stereotactic body radiation therapy (SBRT) is potentially as effective as surgery. However, specialist views of the current evidence about SBRT and how they would incorporate a randomized controlled trial (RCT) into practice is unclear. We sought to understand specialist opinions about evidence regarding treatment of stage I NSCLC and how this translates into practice and clinical trial implementation. METHODS AND MATERIALS: We used a 28-item, web-based survey that invited all participating providers from the American Society for Radiation Oncology, American Thoracic Society Thoracic Oncology Assembly, and the International Association for the Study of Lung Cancer to share opinions regarding practice beliefs, treatment of stage I NSCLC, and a clinical trial scenario. RESULTS: A total of 959 surveys were completed; 64% were from radiation oncologists (ROs) and 49% were from outside the United States. The majority of ROs (80%) reported that current evidence indicates that SBRT has the same or a better benefit compared with surgery for surgically eligible patients with stage I NSCLC; 28% of non–radiation oncologists (NROs) indicated the same (P < .01). Almost all ROs (94%), compared with 62% of NROs, would permit surgically eligible patients to enroll in an RCT of SBRT versus surgery (P < .01). Most ROs (82%) and NROs (87%) believed that changing practice in thoracic surgery would be somewhat difficult, very difficult, or impossible (P = .066) even if an RCT showed better survival with SBRT. CONCLUSIONS: NROs believe that SBRT is much less effective than surgery, contrary to ROs, who believe that they are similar. Most would support an RCT, but NROs would do so less. Changes in surgical practice may be challenging even if an RCT shows better mortality and quality of life with SBRT. These results are helpful in the creation and dissemination of RCTs that are designed to understand this question. Elsevier 2018-01-31 /pmc/articles/PMC6000198/ /pubmed/29904736 http://dx.doi.org/10.1016/j.adro.2018.01.001 Text en http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Lung Cancer Lammers, Austin Mitin, Timur Moghanaki, Drew Thomas, Charles R. Timmerman, Robert Golden, Sara E. Thakurta, Sujata Dziadziuszko, Rafal Slatore, Christopher G. Lung cancer specialists' opinions on treatment for stage I non-small cell lung cancer: A multidisciplinary survey |
title | Lung cancer specialists' opinions on treatment for stage I non-small cell lung cancer: A multidisciplinary survey |
title_full | Lung cancer specialists' opinions on treatment for stage I non-small cell lung cancer: A multidisciplinary survey |
title_fullStr | Lung cancer specialists' opinions on treatment for stage I non-small cell lung cancer: A multidisciplinary survey |
title_full_unstemmed | Lung cancer specialists' opinions on treatment for stage I non-small cell lung cancer: A multidisciplinary survey |
title_short | Lung cancer specialists' opinions on treatment for stage I non-small cell lung cancer: A multidisciplinary survey |
title_sort | lung cancer specialists' opinions on treatment for stage i non-small cell lung cancer: a multidisciplinary survey |
topic | Lung Cancer |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6000198/ https://www.ncbi.nlm.nih.gov/pubmed/29904736 http://dx.doi.org/10.1016/j.adro.2018.01.001 |
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