A Review of Chemotherapy and Radiotherapy Near the End of Life in Individuals with Metastatic Non-small Cell Lung Cancer
, , , , , and | Sep 08, 2020
About this article
Article Category: Research Article
Published Online: Sep 08, 2020
Page range: 29 - 38
Received: Jul 14, 2017
Accepted: Nov 05, 2019
DOI: https://doi.org/10.2478/fco-2019-0013
Keywords
© 2020 Benjamin C. Li et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Figure 1
Figure 2
Patient Characteristics.
| Age at Diagnosis (years) ± quartiles | 60 69 76 | - - | - - |
| Survival after Diagnosis (months) | 2.4 4.8 12.0 | - | - |
| Diagnosis to Treatment (months) | - | 0.4 0.9 1.5 | 0.3 0.7 1.4 |
| Treatment to Death (months) | - - | 2.8 6.4 13.2 | 1.8 4.3 10.0 |
| Male | Female | 58% | 42% | 58% | 42% | 60% | 40% |
| White | Non-White | 83% | 17% | ||
| Patients Diagnosed 1995 to 2010 | N = 48,858 | 44% | 44% |
| Treatment Before Death | |||
| CHT and XRT | 11,983 | 100% | 100% |
| CHT and not XRT | 9,590 | 100% | 0% |
| XRT and not CHT | 9,650 | 0% | 100% |
| Neither | 17,635 | 0% | 0% |
| Marital Status | |||
| Married | 27,592 | 49% | 46% |
| Widowed | 8,180 | 32% | 36% |
| Single | 6,152 | 42% | 45% |
| Divorced | 5,586 | 44% | 47% |
| Unknown | 1,348 | 38% | 46% |
| SES | |||
| Low | 6,901 | 50% | 45% |
| Middle | 33,430 | 44% | 44% |
| High | 8,527 | 40% | 46% |
| Insurance Status | |||
| Insured | 39,575 | 44% | 43% |
| Medicare | 26,302 | 39% | 39% |
| Private | 9,947 | 55% | 48% |
| Medicaid | 2,476 | 48% | 52% |
| Military | 895 | 45% | 58% |
| Not insured | 2,443 | 42% | 48% |
| Unknown | 6,840 | 46% | 51% |
Timing of treatment initiation in Stage IV NSCLC Patients from 1995 – 2010.
| > 60 days from death | 72.9% | 73.9% | 72.3% | 72.6% | 73.4% | 72.9% | 72.3% | 76.3% | |
| 31–60 days from death | 14.0% | 12.9% | 15.1% | 14.3% | 13.2% | 14.0% | 14.7% | 12.6% | |
| 15–30 days from death | 7.3% | 8.3% | 7.4% | 7.8% | 7.9% | 7.5% | 7.9% | 7.0% | |
| 0–14 days from death | 5.8% | 5.0% | 5.1% | 5.3% | 5.6% | 5.6% | 5.1% | 4.0% | |
| > 60 days from death | 81.6% | 82.7% | 82.7% | 82.6% | 83.4% | 84.0% | 83.7% | 85.2% | |
| 31–60 days from death | 9.2% | 8.3% | 9.0% | 9.5% | 8.7% | 8.5% | 8.8% | 7.7% | |
| 15–30 days from death | 5.2% | 5.3% | 5.1% | 4.5% | 4.1% | 4.8% | 4.4% | 3.9% | |
| 0–14 days from death | 4.0% | 3.8% | 3.2% | 3.4% | 3.7% | 2.7% | 3.1% | 3.2% | |
Factors Impacting Utilization.
| Characteristic | OR | 95% CI | P (Wald statistics) |
| Age 70: 65 | 0.897 | (0.887, 0.908) | < 0.0001 |
| Low SES: Middle SES | 1.015 | (0.959, 1.074) | |
| 0.173 | |||
| Low SES: High SES | 1.073 | (0.992, 1.160) | |
| Not Married: Married | 0.938 | (0.896, 0.982) | 0.006 |
| Not Insured: Insured | 0.852 | (0.721, 1.007) | < 0.0001 |
| Female: Male | 0.863 | (0.826, 0.903) | < 0.0001 |
| CHT Received-Yes: No | 0.593 | (0.567, 0.619) | < 0.0001 |
| Characteristic | OR | 95% CI | P (Wald Statistics) |
| Age 70: 65 | 0.824 | (0.814, 0.834) | < 0.0001 |
| Low SES: Middle SES | 0.830 | (0.783, 0.880) | |
| < 0.0001 | |||
| Low SES: High SES | 0.681 | (0.629, 0.738) | |
| Not Married: Married | 0.702 | (0.671, 0.736) | < 0.0001 |
| Not Insured: Insured | 0.678 | (0.572, 0.804) | < 0.0001 |
| Female: Male | 1.077 | (1.029, 1.127) | 0.001 |
| XRT Received-Yes: No | 0.593 | (0.568, 0.620) | < 0.0001 |