Evidence map›Paper›PMID 26424779›Full record

ArticleJournal of the National Cancer Institute2015

Prevalence and Predictors of Inappropriate Delivery of Palliative Thoracic Radiotherapy for Metastatic Lung Cancer.

Matthew Koshy, Renuka Malik, Usama Mahmood, Zain Husain, Ralph R Weichselbaum, David J Sher

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the National Cancer Institute, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
4.3field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 22 citations in OpenAlex.

  1. Article
  2. Observational
  3. Article
  4. Audit of 30-day mortality following palliative radiotherapy: are we able to improve patient care at the end of life?Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2023
    Article
  5. Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Matthew KoshyDepartment of Radiation Oncology, University of Illinois at Chicago, Chicago, IL (MK, RRW); Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL (MK, RM, RRW); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (UM); Department of Radiation Oncology, Yale University, New Haven, CT (ZH); Department of Radiation Oncology, Rush University Medical Center, Chicago, IL (DJS). mkoshy@radonc.uchicago.edu.
Renuka MalikDepartment of Radiation Oncology, University of Illinois at Chicago, Chicago, IL (MK, RRW); Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL (MK, RM, RRW); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (UM); Department of Radiation Oncology, Yale University, New Haven, CT (ZH); Department of Radiation Oncology, Rush University Medical Center, Chicago, IL (DJS).
Usama MahmoodDepartment of Radiation Oncology, University of Illinois at Chicago, Chicago, IL (MK, RRW); Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL (MK, RM, RRW); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (UM); Department of Radiation Oncology, Yale University, New Haven, CT (ZH); Department of Radiation Oncology, Rush University Medical Center, Chicago, IL (DJS).
Zain HusainDepartment of Radiation Oncology, University of Illinois at Chicago, Chicago, IL (MK, RRW); Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL (MK, RM, RRW); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (UM); Department of Radiation Oncology, Yale University, New Haven, CT (ZH); Department of Radiation Oncology, Rush University Medical Center, Chicago, IL (DJS).
Ralph R WeichselbaumDepartment of Radiation Oncology, University of Illinois at Chicago, Chicago, IL (MK, RRW); Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL (MK, RM, RRW); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (UM); Department of Radiation Oncology, Yale University, New Haven, CT (ZH); Department of Radiation Oncology, Rush University Medical Center, Chicago, IL (DJS).
David J SherDepartment of Radiation Oncology, University of Illinois at Chicago, Chicago, IL (MK, RRW); Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL (MK, RM, RRW); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (UM); Department of Radiation Oncology, Yale University, New Haven, CT (ZH); Department of Radiation Oncology, Rush University Medical Center, Chicago, IL (DJS).
The University of Texas MD Anderson Cancer Center · USUniversity of Illinois Chicago · USUniversity of Chicago · USYale University · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Fabien Delerue · 1985 to 2026
$290.8M
6 · The paper itself

Abstract

backgroundHigh-level evidence has established well-recognized standard treatment regimens for patients undergoing palliative chest radiotherapy (RT) for stage IV non-small cell lung cancer (NSCLC), including treating with fewer than 15 fractions of RT, and not delivering concurrent chemoradiation (CRT) because of its increased toxicity and limited efficacy in the palliative setting.

methodsThe study included patients in the National Cancer Database from 2004 to 2012 with stage IV lung cancer who received palliative chest radiation therapy. Logistic regression was performed to determine predictors of standard vs nonstandard regimens (>15 fractions or CRT). All statistical tests were two-sided.

resultsThere were 46 803 patients in the analysis and 49% received radiotherapy for longer than 15 fractions, and 28% received greater than 25 fractions. Approximately 19% received CRT. The strongest independent predictors of long-course RT were private insurance (odds ratio [OR] = 1.40 vs uninsured, 95% confidence interval [CI] = 1.28 to 1.53) and treatment in community cancer programs (OR = 1.49, 95% CI = 1.38 to 1.58) compared with academic research programs. The strongest factors that predicted for concurrent chemoradiotherapy were private insurance (OR = 1.38 95% CI = 1.23 to 1.54) compared with uninsured patients and treatment in community cancer programs (OR = 1.44, 95% CI = 1.33 to 1.56) compared with academic programs.

conclusionsApproximately half of all patients with metastatic lung cancer received a higher number of radiation fractions than recommended. Patients with private insurance and treated in community cancer centers were more likely to receive longer courses of RT or CRT. This demonstrates that a substantial number of patients requiring palliative thoracic radiotherapy are overtreated and further work is necessary to ensure these patients are treated according to evidenced-based guidelines.

Indexed as

Academic Medical CentersAdultAgedAged, 80 and overCarcinoma, Non-Small-Cell LungChemoradiotherapyCommunity Health ServicesDatabases, FactualDose Fractionation, RadiationFemaleHumansInsurance, HealthLogistic ModelsLung NeoplasmsMaleMiddle Aged

Identifiers

PMID26424779
PMCPMC4862415
OpenAlexW2419527410

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.