IntroductionDespite the availability of radiotherapy treatment protocols for lung cancer, considerable treatment variation occurs in clinical practice. This study assessed compliance with a radiotherapy protocol for the treatment of patients with stages I–III non‐small‐cell lung cancer (NSCLC) in routine clinical practice and to identify factors that were associated with compliance.MethodsThe Cancer Institute New South Wales eviQ treatment protocol for external beam radiotherapy of stages I–III NSCLC was taken as the reference to measure compliance. All inoperable patients with stages I–III NSCLC and documented ECOG performance status treated with radiotherapy between 2007 and 2019 at two radiotherapy facilities were available for analysis. Protocol compliance rates were calculated. Univariate and multivariate logistic regression models with 23 input factors were used to determine factors significantly associated with compliance. Survival analysis was conducted for both compliant and non‐compliant treatments.ResultsOverall, 656 patients met the inclusion criteria. Protocol compliance was 16%. Alternative dose/fractionation was responsible for 49% of non‐compliant treatments with 30% receiving an alternative curative fractionation. Five of 23 factors (age at the start of radiotherapy, stage group, ECOG performance status, tumour location and alcoholism history) showed significant associations with protocol compliance on multivariate analysis. There was no significant difference in median survival between patients receiving protocol compliant treatment (15.1 months) and non‐compliant treatment (15.6 months).ConclusionAdherence to the eviQ curative radiotherapy protocol for stages I–III NSCLC was low. Alternative dose/fractionation schemes were the main reason for non‐compliance. Protocol compliance was not associated with outcome.

中文翻译：

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I-III 期非小细胞肺癌患者常规临床实践中的放疗方案依从性


引言尽管肺癌的放疗方案可用，但在临床实践中仍存在相当大的治疗差异。本研究评估了常规临床实践中对 I-III 期非小细胞肺癌 （NSCLC） 患者治疗放疗方案的依从性，并确定了与依从性相关的因素。方法以新南威尔士州癌症研究所 I-III 期 NSCLC 外照射放疗的 eviQ 治疗方案为参考，衡量依从性。所有不能手术的 I-III 期 NSCLC 患者和 2007 年至 2019 年期间在两个放疗机构接受放疗的 ECOG 体能状态均可用于分析。计算方案依从率。具有 23 个输入因素的单变量和多变量 logistic 回归模型用于确定与依从性显著相关的因素。对依从性和非依从性治疗进行生存分析。结果总体而言，656 例患者符合纳入标准。方案依从率为 16%。替代剂量/分割治疗导致 49% 的不依从治疗，其中 30% 接受替代治愈性分割。23 个因素中的 5 个 （放疗开始时的年龄、分期组、ECOG 体能状态、肿瘤位置和酗酒史） 在多变量分析中与方案依从性呈显著关联。接受方案依从治疗 （15.1 个月） 和不依从治疗 （15.6 个月） 的患者之间中位生存期无显著差异。结论I-III 期 NSCLC 对 eviQ 治愈性放疗方案的依从性较低。 替代剂量/分馏方案是不依从性的主要原因。方案依从性与结局无关。