Use of Adjuvant Cisplatin-Based Versus Carboplatin-Based Chemotherapy in Non-Small-Cell Lung Cancer: Findings From the Florida Initiative for Quality Cancer Care.

Abstract

PURPOSE:

For patients with resected non-small-cell lung cancer, national guidelines recommend cisplatin-based doublet chemotherapy as the preferred treatment. However, many patients receive a carboplatin-based regimen instead. We aimed to identify factors associated with use of a cisplatin-based regimen and explore its association with other quality-of-care measures.

METHODS:

This analysis was part of the Florida Initiative for Quality Cancer Care, an audit and feedback project among 11 medical oncology practices. Feedback-sharing sessions based on findings of year 2006 took place in 2008. Eligible patients were random samples of those with resected stage I to III non-small-cell lung cancer treated in 2006 and 2009.

RESULTS:

In both years combined, 81 patients received adjuvant platinum-based doublets: 33 patients (41%) received cisplatin, and 48 patients (59%) received carboplatin. Use of a cisplatin-based doublet significantly increased in 2009 compared with 2006, from 24% to 56% (P = .006). Multivariable analysis determined that academic practices used cisplatin more frequently than nonacademic practices (odds ratios, 3.26; 95% CI, 1.19 to 8.91; P = .02). Moreover, patients treated in 2009 were more likely to receive cisplatin than those treated in 2006 (odds ratio, 4.89; 95% CI, 1.75 to 13.67; P = .002). No significant association between use of cisplatin and other quality-of-care measures was found.

CONCLUSION:

In this study, academic practice status and treatment year predicted use of adjuvant cisplatin-based chemotherapy. The increase in use of cisplatin in 2009, as compared with 2006, suggests that audit and feedback may be effective ways to promote such use.

• Authors: Tawee Tanvetyanon, Ji-Hyun Lee, William J Fulp, Fred Schreiber, Richard H Brown, Richard M Levine, Thomas H Cartwright, Guillermo Abesada-Terk, George P Kim, Carlos Alemany, Douglas Faig, Philip V Sharp, Merry-Jennifer Markham, Mokenge Malafa, Paul B Jacobsen
• Journal: Journal of oncology practice (J Oncol Pract) Vol. 11 Issue 4 Pg. 332-7 (Jul 2015) ISSN: 1935-469X [Electronic] United States
• PMID: 25991639 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 by American Society of Clinical Oncology.

Chemical References

• Taxoids
• Deoxycytidine
• Docetaxel
• Vinblastine
• Etoposide
• Carboplatin
• Paclitaxel
• Cisplatin
• Vinorelbine
• Gemcitabine

Topics

• Academic Medical Centers
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carboplatin (administration & dosage)
• Carcinoma, Non-Small-Cell Lung (drug therapy, pathology, surgery)
• Chemotherapy, Adjuvant
• Cisplatin (administration & dosage)
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Docetaxel
• Etoposide (administration & dosage)
• Female
• Florida
• Humans
• Lung Neoplasms (drug therapy, pathology, surgery)
• Male
• Medical Audit
• Middle Aged
• Paclitaxel (administration & dosage)
• Pneumonectomy
• Practice Patterns, Physicians'
• Quality of Health Care
• Taxoids (administration & dosage)
• Time Factors
• Vinblastine (administration & dosage, analogs & derivatives)
• Vinorelbine
• Gemcitabine