P1.17-04 Curative Intent Treatment for Stage III NSCLC in England

Abstract

The National Lung Cancer Audit (NLCA) produces annual reports detailing standards of care for lung cancer. This further analysis investigates the use of curative intent multi-modality treatment for people in England diagnosed with stage III NSCLC during 2016, including, for the first time, details about use of concurrent and sequential chemoradiation (cRT). Data on patients diagnosed during 2016 with stage III NSCLC in England were extracted from the National Cancer Registration and Analysis Service (NCRAS); information submitted through the Cancer Outcome and Services Dataset (COSD) were linked to other NCRAS datasets, including Hospital Episode Statistics (HES), the National Radiotherapy Dataset (RTDS) and the Systemic Anti-Cancer Dataset (SACT). 6,288 cases of stage III NSCLC were analysed, 3839 Stage IIIA and 2449 Stage IIIB (Table 1). 813 (13%) people underwent surgery with 447 (7%) of these also receiving chemotherapy (predominantly adjuvant). 1047 (17%) people were treated with radical radiotherapy with 676 (11%) of these also receiving chemotherapy. For the 589/676 cRT cases where complete treatment dates were available, 199 (34%) received concurrent and 390 (66%) received sequential chemoRT (37% and 63% for stage IIIA). For 481/589 cases with performance status (PS) available, 171 (36%) PS0-1 cases received concurrent and 310 (64%) received sequential cRT (38% and 62% for stage IIIA) Of note, 2148 (34%) people received anti-cancer treatment of palliative intent and 2290 (36%) received supportive care only. Survival data will also be presented. Table 1 Multi-modality treatment with either surgery or radical radiotherapy combined with chemotherapy was delivered to 1123 (18%) patients with stage III NSCLC. Concurrent cRT, optimal cRT based on meta-analysis, was delivered to just over one third of people receiving cRT, including for patients of good PS0-1. This analysis provides a baseline for future quality improvement initiatives to optimise treatment and outcomes for patients with stage III NSCLC.