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Patterns of Care and Barriers to Utilization of Definitive Concurrent Chemoradiation Therapy for Stage III Non-Small Cell Lung Cancer in Russia

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Abstract

Background

Definitive concurrent chemoradiation (cCRT) is offered to only 3% of Russian patients with stage III NSCLC. To determine the patterns of care and barriers to cCRT utilization in Russia, we conducted a survey of practicing radiation oncologists (ROs).

Methods

Electronic IRB-approved survey containing 15 questions was distributed to Russian ROs. Fisher’s exact test or Cochran-Armitage test of trend was used to assess the associations between clinical experience, practice type, and patterns of care.

Results

We analyzed 58 questionnaires completed by ROs—16 respondents from tertiary referral hospitals, and 42 from community or private centers. A total of 88% of respondents formulate treatment recommendations in multi-disciplinary tumor boards. For unresectable stage III NSCLC, the most common recommendation is sequential CRT (50%), followed by concurrent CRT (40%), with an observed higher utilization of cCRT in tertiary centers (9/16, 56% vs 14/42, 33%). Of the respondents, 31% do not offer cCRT to their pts. Among reasons for avoiding cCRT are (1) poor performance of pts (76%); (2) high toxicity of therapy (55%); (3) lack of consensus among tumor board members (33%); and (4) preference for sequential CRT (31%). Only 3% do not irradiate elective LNs. Eighty-six percent of respondents counsel their NSCLC pts regarding smoking cessation.

Conclusions

Despite level 1 evidence, cCRT is rarely used in Russia for pts with locally advanced NSCLC, and preference for sequential therapy and concerns over high toxicity are the most common barriers. Education of Russian ROs may increase cCRT utilization, leading to improved survival, notably in the era of maintenance immunotherapy.

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References

  1. Torre LA, Bray F, Siegel RL et al (2015) Global cancer statistics, 2012. CA Cancer J Clin 65:87–108

    Article  Google Scholar 

  2. Kaprin AD, Starinsky VV, Petrova GV (eds) (2019) Malignant neoplasms in Russia in 2018 (morbidity and mortality). P.A. Gertzen Cancer Research Institute Moscow: Ministry of Health of Russian Federation, Moscow, Russia (book in Russian)

  3. Chargari C, Soria JC, Deutsch E (2012) Controversies and challenges regarding the impact of radiation therapy on survival. Ann Oncol 00:1–9

    Google Scholar 

  4. Antonia SJ, Villegas A, Daniel D, Vicente D, Murakami S, Hui R, Yokoi T, Chiappori A, Lee KH, de Wit M, Cho BC, Bourhaba M, Quantin X, Tokito T, Mekhail T, Planchard D, Kim YC, Karapetis CS, Hiret S, Ostoros G, Kubota K, Gray JE, Paz-Ares L, de Castro Carpeño J, Wadsworth C, Melillo G, Jiang H, Huang Y, Dennis PA, Özgüroğlu M (2017) Durvalumab after chemoradiotherapy in stage III non–small-cell lung cancer. N Engl J Med 377:1919–1929

    Article  CAS  Google Scholar 

  5. O’Rourke N, Roqué I Figuls M, Farré Bernadó N, Macbeth F (2010) Concurrent chemoradiotherapy in non-small cell lung cancer. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD002140.pub3

  6. Auperin A, Le Pechoux С, Rolland E et al (2010) Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non–small-cell lung cancer. J Clin Oncol 28(13):2181–2190

    Article  CAS  Google Scholar 

  7. Vokes EE, Herndon JE II, Kelley MJ et al (2007) Induction chemotherapy followed by chemoradiotherapy compared with chemoradiotherapy alone for regionally advanced unresectable stage III non–small-cell lung cancer: Cancer and Leukemia Group B. J Clin Oncol 25(13):1698–1704

    Article  CAS  Google Scholar 

  8. Belani CP, Choy H, Bonomi P, Scott C, Travis P, Haluschak J, Curran WJ Jr (2005) Combined chemoradiotherapy regimens of paclitaxel and carboplatin for locally advanced non-small-cell lung cancer: a randomized phase II locally advanced multi-modality protocol. J Clin Oncol 23:5883–5891

    Article  CAS  Google Scholar 

  9. Hanna N, Neubauer M, Yiannoutsos C, McGarry R, Arseneau J, Ansari R, Reynolds C, Govindan R, Melnyk A, Fisher W, Richards D, Bruetman D, Anderson T, Chowhan N, Nattam S, Mantravadi P, Johnson C, Breen T, White A, Einhorn L, Hoosier Oncology Group, US Oncology (2008) Phase III study of cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel in patients with inoperable stage III non-small-cell lung cancer: the Hoosier Oncology Group and U.S.Oncology. J Clin Oncol 26:5755–5760

    Article  CAS  Google Scholar 

  10. Jalal SI, Riggs HD, Melnyk A, Richards D, Agarwala A, Neubauer M, Ansari R, Govindan R, Bruetman D, Fisher W, Breen T, Johnson CS, Yu M, Einhorn L, Hanna N (2012) Updated survival and outcomes for older adults with inoperable stage III non-small-cell lung cancer treated with cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel: analysis of a phase III trial from the Hoosier Oncology Group (HOG) and US Oncology. Ann Oncol 23:1730–1738

    Article  CAS  Google Scholar 

  11. Kaprin AD, Starinsky VV, Petrova GV (eds) (2018) The state of oncological care for the population of Russia in 2017. P.A. Gertzen Cancer Research Institute Moscow: Ministry of Health of Russian Federation, Moscow, Russia (book in Russian)

  12. Kaprin AD, Starinsky VV, Petrova GV (eds) (2019) The state of oncological care for the population of Russia in 2018. P.A. Gertzen Cancer Research Institute Moscow: Ministry of Health of Russian Federation, Moscow, Russia (book in Russian)

  13. Miller KD, Siegel RL, Lin CC, Mariotto AB, Kramer JL, Rowland JH, Stein KD, Alteri R, Jemal A (2016) Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin 66(4):271–289

    Article  Google Scholar 

  14. Fernandes AT, Shen J, Finlay J, Mitra N, Evans T, Stevenson J, Langer C, Lin L, Hahn S, Glatstein E, Rengan R (2010) Elective nodal irradiation (ENI) vs. involved field radiotherapy (IFRT) for locally advanced non-small cell lung cancer (NSCLC): a comparative analysis of toxicities and clinical outcomes. Radiother Oncol 95(2):178–184

    Article  Google Scholar 

  15. Mitin T, Dengina N, Chernykh M, Usychkin S, Gladkov O, Degnin C, Chen Y, Nosov D, Tsimafeyeu I, Thomas CR Jr, Tjulandin S (2020) Management of muscle invasive bladder cancer with bladder preservation in Russia: a survey-based analysis of current practice and the impact of an educational workshop on clinical expertise. J Cancer Educ. https://doi.org/10.1007/s13187-020-01728-y

  16. Mitin T, Degnin C, Chen Y, Shirvani S, Gillespie E, Hoffe S, Latifi K, Nabavizadeh N, Dengina N, Chernich M, Usychkin S, Kharitonova E, Egorova Y, Pankratov A, Tsimafeyeu I, Thomas CR Jr, Tjulandin S, Likhacheva A (2020) Radiotherapy for hepatocellular carcinoma in Russia: a survey-based analysis of current practice and the impact of an educational workshop on clinical expertise. J Cancer Educ 35(1):105–111

    Article  Google Scholar 

  17. McClelland S 3rd, Chernykh M, Dengina N et al (2019) Bridging the gap in global advanced radiation oncology training: impact of a web-based open-access interactive three-dimensional contouring atlas on radiation oncologist practice in Russia. J Cancer Educ 34(5):871–873

    Article  Google Scholar 

  18. Likhacheva A et al (2017) The red beam: past, present, and future of radiation oncology in Russia. IJROBP 97(2):220–224

    Google Scholar 

  19. Aggarwal C, Li L, Borghaei H et al (2014) Multidisciplinary therapy of stage IIIA non-small-cell lung cancer: long-term outcome of chemoradiation with or without surgery. Cancer Control 21(1):57–62

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Radiotherapy, Ulyanovsk Regional Cancer Center, Ulyanovsk, Oblast, Russia

    Natalia Dengina

  2. PET-Technology Podolsk, Podolsk, Russia

    Marina Chernykh

  3. Biostatics Shared Resources, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA

    Catherine Degnin & Yiyi Chen

  4. Department of Radiation Medicine, Knight Cancer Institute, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, KPV4, Portland, OR, 97239, USA

    Yiyi Chen, Charles R. Thomas Jr & Timur Mitin

  5. Institute of Oncology, Hadassah Medical, Moscow, Russia

    Ilya Tsimafeyeu

  6. Russian Society of Clinical Oncology, Moscow, Russia

    Vera V. Karaseva

  7. N.N. Blokhin Russian Cancer Center, Moscow, Russia

    Sergei Tjulandin & Konstantin Laktionov

Authors
  1. Natalia Dengina
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  2. Marina Chernykh
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  3. Catherine Degnin
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  4. Yiyi Chen
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  5. Ilya Tsimafeyeu
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  6. Vera V. Karaseva
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  7. Sergei Tjulandin
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  8. Konstantin Laktionov
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  9. Charles R. Thomas Jr
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  10. Timur Mitin
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Contributions

ND, MC, and TM designed the study; CD and YC performed data analysis; ND, MC, IT, VK, ST, KL, CRT, and TM carried out the study and reviewed the drafted manuscript, and participated in finalizing the manuscript.

Corresponding author

Correspondence to Timur Mitin.

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Oregon Health and Sciences University, IRB protocol 11149

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The authors have no competing interests.

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Dengina, N., Chernykh, M., Degnin, C. et al. Patterns of Care and Barriers to Utilization of Definitive Concurrent Chemoradiation Therapy for Stage III Non-Small Cell Lung Cancer in Russia. J Canc Educ 37, 1378–1384 (2022). https://doi.org/10.1007/s13187-021-01966-8

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  • DOI: https://doi.org/10.1007/s13187-021-01966-8

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