Underutilization of Curative Treatment among Patients with Non Small Cell Lung Cancer: Experience from a Tertiary Care Centre in India

Background: Lung cancer is one of the commonest and most lethal cancers throughout the world. The majorityof the patients present at advance stage and are not suitable for curative intent treatment. Even among patientswith localized disease, there has been underutilization of curative treatment modalities. The aim of this study wasto analyze the radical treatment utilization rates in patients with non small cell lung cancer (NSCLC) treated atour centre. Materials and
Methods: We analyzed case records of 104 patients with a pathologically confirmeddiagnosis of NSCLC having stage 1-3B disease who were treated at our centre over last 3 years, to assess theutilization of curative treatment modalities i.e. surgery or radical radiotherapy.
Results: The median age of thiscohort was 58 years. Out of 104 patients only 33 (31.7%) received curative intent treatment, 14 undergoing curativeresection and 19 receiving radical doses of radiotherapy. The baseline characteristics of both the groups (withor without radical treatment) were not different. Major factors associated with underutilization with curativetreatment were progressive disease or loss of follow up after chemotherapy and inappropriate use of TKI and/or palliative radiotherapy in patients with stage 1-3B disease. Patients who did not receive radical treatmenthad inferior PFS and OS than those who received radical treatment.
Conclusions: In our practice we observedgross underutilization of curative intent treatment modalities in patients with NSCLCs which is associated withinferior survival.