Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
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Combined modality therapy (CMT; radiation and chemotherapy) is indicated for fit, elderly patients with inoperable, locally advanced non-small cell lung cancer. We used population level data to examine effects of CMT on survival. ⋯ Survival benefits associated with CMT in clinical trials can extend to the elderly in routine care settings. CMT-ONLY is associated with the greatest mortality risk, suggesting that more gradual strategies (CMT-IND) may be more appropriate for the elderly population.
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Disparities in treatment exist for nonwhite and Hispanic patients with non-small cell lung cancer, but little is known about disparities in the use of staging tests or their underlying causes. ⋯ Hispanics and nonwhites with non-small cell lung cancer are less likely to receive PET imaging. This finding is consistent across subgroups and not explained by differences in income, education, or insurance coverage.
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Comparative Study
Characteristics and outcomes of small cell lung cancer patients diagnosed during two lung cancer computed tomographic screening programs in heavy smokers.
Small cell lung cancer (SCLC) is considered an inappropriate screening target due to its short preclinical phase and high rate of relapse despite optimal therapy. However, while intuitively screening for SCLC is inadvisable, in reality, there is a scarcity of data focusing on screen-detected SCLC and whether this intervention leads to diagnosis at an earlier clinical stage or alters outcome. ⋯ This study suggests that computed tomography screening is ineffective for SCLC. Efforts to reduce mortality of SCLC should instead focus on prevention through tobacco reduction programs, as well as the development of improved treatment options.