Initial inspection and standards of treatment of limited small cell lung cancer - a combination of chemotherapy and radiation therapy , but a new study shows that a significant proportion of patients are not receiving optimal treatment.
The resulting data from a large population-based studies have shown that 23% of patients not receiving chemotherapy, and 41% - radiation therapy. The overall survival of these patients was significantly lower than patients receiving both therapies. The researchers drew attention to the role of insurance in the treatment of type.
The American public insurance (Medicaid or Medicare) did not affect the receipt of chemotherapy, while radiation therapy is not covered by insurance, and patients were less likely it.
The study is published online Jan. 4 in JAMA Oncology.
Stephen Cheung, lead author, MD, associate professor of radiation oncology at the University of Texas, said that, unlike some types of cancer, about the standards of treatment of lung cancer is being limited small cell much less discussion. (Learn about the treatment of lung cancer in Israel ).
"Such a standard treatment existed for 30 years - said Dr. Chun edition Medscape Medical News. - Although there may be legitimate reasons why some patients do not undergo chemo therapy, we have also found a link with insurance. "
He explained that patients who have federal insurance still does not always receive radiation therapy compared with those who designed other types of insurance. In the case of chemotherapy, there was no difference between patients with private insurance and those who have Medicare or Medicaid.
The discrepancy can be explained by the fact that programs such as 340b and Medicaid Drug Discount Program, improved access to chemotherapy. "These programs provide a good competitive compensation, and evidence suggests that they are expanding access to medicines, - says Dr. Chung. - At the same time, we found that the federal insurance does not cover expenses for radiation therapy. We need to understand how to align this situation. It is one thing to know the standards of care, and the other - to implement them in a way that they are effective. "
For their study, Dr. Cheung and his colleagues used a national database on cancer and identified 70,247 patients who were diagnosed with small cell lung cancer limited to the period from 2004 to 2013.