Real-World Patients Management and Referral Patterns in Patients With Stage III Unresectable Non-Small Cell Lung...

Area of Science:

• Oncology
• Radiotherapy
• Clinical Practice

Background:

• Unresectable stage III non-small cell lung cancer (NSCLC) requires complex treatment strategies.
• Consolidation immunotherapy is being implemented nationally, impacting treatment paradigms.
• Understanding current clinical practices is crucial for optimizing patient care.

Purpose of the Study:

• To analyze referral patterns and clinical practice for unresectable stage III NSCLC in Poland.
• To evaluate the use of concurrent chemoradiotherapy (cCRT), sequential chemoradiotherapy (sCRT), and definitive radiotherapy (dRT) during early immunotherapy implementation.
• To identify factors influencing treatment selection.

Main Methods:

• Multicenter observational study of 273 adult patients with unresectable stage III NSCLC.
• Data collected on patients treated with curative-intent radiotherapy between April 2021 and March 2022.
• Descriptive analyses and group comparisons using statistical tests (Fisher's exact, chi-squared, Kruskal-Wallis).

Main Results:

• Concurrent chemoradiotherapy (cCRT) and sequential chemoradiotherapy (sCRT) were used with equal frequency (37.7% each).
• Definitive radiotherapy (dRT) was used in 16.5% of cases.
• Treatment choice was influenced by performance status (PS) and tumor characteristics (location, mass), not solely by UICC-TNM staging. Grade 3-4 hematologic toxicity was more frequent with cCRT.

Conclusions:

• Concurrent chemoradiotherapy (cCRT) and sequential chemoradiotherapy (sCRT) demonstrate equal utilization in Poland for unresectable stage III NSCLC.
• Performance status and specific tumor attributes significantly guide treatment decisions.
• Current practices reflect a nuanced approach beyond standard staging criteria.