Progress in Standard of Care Therapy and Modest Survival Benefits in the Treatment of Non-small Cell Lung Cancer Patients in the Netherlands in the Last 20 Years

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Drift, M.A. van der and Karim-Kos, H.E. and Siesling, S. and Groen, H.J.M. and Wouters, M.W.J.M. and Coebergh, J.W.W. and Vries, E. de and Janssen-Heijnen, M.L.G. (2012) Progress in Standard of Care Therapy and Modest Survival Benefits in the Treatment of Non-small Cell Lung Cancer Patients in the Netherlands in the Last 20 Years. Journal of thoracic oncology, 7 (2). 291 - 298. ISSN 1556-0864

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Abstract:Introduction: Lung cancer is the leading cause of cancer mortality worldwide. We analyzed changes in treatment and their potential effect on survival of non-small cell lung cancer (NSCLC) patients in the Netherlands.

Methods: All NSCLC patients diagnosed during 1989–2009 (n=147,760) were selected from the population-based Netherlands Cancer Registry. Differences in treatment over time were tested by the Cochran-Armitage trend test. The effects of sex, age, histology, and treatment on relative survival were estimated in multivariable models. Follow-up was completed until January 1, 2010.

Results: Between 1989 and 2009, the proportion of younger patients (younger than 75 years) with stage I undergoing surgery increased from 84 to 89% and among elderly (75 years or elder) from 35 to 49%; for stage II, this proportion decreased from 80 to 70% and remained about 25% in respectively younger and older patients. Adjuvant chemotherapy for stage II increased to from 0 to 24% in younger patients but remained less than 5% among the elderly. Chemoradiation increased from 8 to 43% among younger patients with stage III and from 1 to 13% among elderly. In stage IV, chemotherapy in younger patients increased from 10 to 54% and in elderly from 5 to 21%. Five-year relative survival of the total group increased from 14.8 to 17% (especially among females, younger patients, and within each stage), which could be partly explained by changes in treatment and better staging.

Conclusions: Over a 20-year period, application of therapy, which is currently considered as standard, has improved. This resulted in small improvements in survival within all stages.
Item Type:Article
Copyright:© 2012 Wolters Kluwer
Faculty:
Management and Governance (SMG)
Link to this item:http://purl.utwente.nl/publications/81783
Official URL:http://dx.doi.org/10.1097/JTO.0b013e31823a01fb
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