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- Title
Lung cancer radiation therapy in Australia and New Zealand: Patterns of practice.
- Authors
Islam, Syed Muntasser; Vinod, Shalini K; Lehman, Margot; Siva, Shankar; Kron, Tomas; Dwyer, Patrick M; Holloway, Lois; Lao, Louis; Yap, Mei Ling; Ruben, Jeremy D
- Abstract
<bold>Introduction: </bold>The RANZCR Faculty of Radiation Oncology Lung Interest Cooperative (FROLIC) surveyed patterns of lung cancer radiation therapy practice for non-small cell (NSCLC) and small cell lung cancer (SCLC) to evaluate current patterns of care and potential for improvement.<bold>Methods: </bold>In October 2014, Radiation Oncologists (ROs) from all 62 departments in Australia and New Zealand were invited to a web-based survey directed at those treating lung cancer. Questions covered current radiation therapy practice as well as quality measures.<bold>Results: </bold>Fifty-eight per cent of respondents used 4D-CT simulation. For curative treatment, 98% employed 3D-CRT and 34% intensity modulated radiotherapy (IMRT) techniques. Treatment verification was primarily performed using cone-beam CT (86%). In NSCLC, the commonest curative dose-fractionation regime was 60 Gy/30# (96%) and for palliative intent, 30 Gy/10# (76%). Forty-four per cent treated patients with stereotactic ablative body radiotherapy (SABR) and half treated central tumours with this technique. In fit patients with synchronous solitary brain metastases, 80% would give radical treatment. For curative-intent SCLC, 45-50.4 Gy/25-28# (61%) and 45 Gy/30#/1.5 Gy b.d. (48%) were used. Ninety-four per cent discussed lung cancer patients at multidisciplinary meetings. Contours were peer-reviewed by 74% and 50% for conventional fractionation and SABR respectively.<bold>Conclusion: </bold>A significant proportion of ROs did not have access to 4D-CT. The majority used 3D image verification and consistently prescribed evidence based doses. A significant number did not participate in peer-review of contours. Practice in IMRT and synchronous oligo-metastatic disease is variable and should be an area of future research. Utilising survey findings, FROLIC is developing consensus recommendations to guide practice.
- Subjects
AUSTRALIA; NEW Zealand; LUNG cancer treatment; RADIOTHERAPY; SMALL cell lung cancer; INTENSITY modulated radiotherapy; TREATMENT of lung tumors; RADIOSURGERY
- Publication
Journal of Medical Imaging & Radiation Oncology, 2016, Vol 60, Issue 5, p677
- ISSN
1754-9477
- Publication type
journal article
- DOI
10.1111/1754-9485.12475