Abstract:
Aims To determine treatment practices of New Zealand physicians who manage nonsmall
cell lung cancer (NSCLC).
Methods A questionnaire on the treatment of NSCLC was emailed to all respiratory
physicians, medical oncologists, and radiation oncologists in New Zealand.
Respondents were asked to select the treatment they would offer in six lung cancer
case scenarios.
Results Thirty-one (81%) respiratory physicians, 15 (71%) medical oncologists, and 8
(30%) radiation oncologists responded to the questionnaire. Surgery was selected (by
all groups) as the best option for early-stage disease NSCLC. Radiotherapy or
combination chemo/radiotherapy (for locally advanced disease) was favoured by 37%
of respiratory physicians for stage IIIa and 28% for stage IIIb—compared with
medical oncologists (100% and 80%) and radiation oncologists (86% and 28%).
Chemotherapy for ‘fit’ patients with advanced disease was favoured by only 11% of
respiratory physicians, compared with 67% of medical oncologists and 33% of
radiation oncologists. Best supportive care (BSC) was the favoured treatment for
patients with advanced disease with poor performance patients.
Conclusion This study demonstrates considerable heterogeneity in the choice of
treatment for NSCLC between specialities, particularly for locally advanced and
advanced disease. These findings suggest international guidelines are not being
adhered to, and variations in treatment may potentially have outcome implications for
patients.