Table 1
Patient Characteristics.
| Characteristic | Diagnosed Patients | CHT Treatment | XRT Treatment |
|---|---|---|---|
| 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% | ||
| % CHT Treated | % XRT Treated | ||
| 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% |
Figure 1
Utilization of CHT and XRT. The percentage of patients that initiated chemotherapy and radiotherapy any time after diagnosis of Stage IV NSCLC is shown. Trends are shown in two-year time frames between 1995 and 2010.
Table 2
Timing of treatment initiation in Stage IV NSCLC Patients from 1995 – 2010.
| Years: | 95–96 | 97–98 | 99–00 | 01–02 | 03–04 | 05–06 | 07–08 | 09–10 | Total |
|---|---|---|---|---|---|---|---|---|---|
| Patients who initiated first course of radiotherapy | |||||||||
| > 60 days from death | 72.9% | 73.9% | 72.3% | 72.6% | 73.4% | 72.9% | 72.3% | 76.3% | 73.3% |
| 31–60 days from death | 14.0% | 12.9% | 15.1% | 14.3% | 13.2% | 14.0% | 14.7% | 12.6% | 13.8% |
| 15–30 days from death | 7.3% | 8.3% | 7.4% | 7.8% | 7.9% | 7.5% | 7.9% | 7.0% | 7.7% |
| 0–14 days from death | 5.8% | 5.0% | 5.1% | 5.3% | 5.6% | 5.6% | 5.1% | 4.0% | 5.2% |
| Patients who initiated first course of chemotherapy | |||||||||
| > 60 days from death | 81.6% | 82.7% | 82.7% | 82.6% | 83.4% | 84.0% | 83.7% | 85.2% | 83.3% |
| 31–60 days from death | 9.2% | 8.3% | 9.0% | 9.5% | 8.7% | 8.5% | 8.8% | 7.7% | 8.1% |
| 15–30 days from death | 5.2% | 5.3% | 5.1% | 4.5% | 4.1% | 4.8% | 4.4% | 3.9% | 5.0% |
| 0–14 days from death | 4.0% | 3.8% | 3.2% | 3.4% | 3.7% | 2.7% | 3.1% | 3.2% | 3.6% |
Figure 2
Initiation of Treatments for Stage IV NSCLC in 60-Day Limited Survival. Only patients with a 60-day or less survival from date of diagnosis to date of death are included. The percentage of patients that initiated radiotherapy (red lines) and chemotherapy (blue lines) within each time frame after diagnosis of Stage IV NSCLC is shown: within 60 days of death, within 30 days of death, and within 14 days of death. Trends are shown in two-year time frames between 1995 and 2010.
Table 3
Factors Impacting Utilization.
| Radiotherapy Received | |||
| 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 |
| Chemotherapy Received | |||
| 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 |