Use of adjuvant cisplatin-based versus carboplatin-based chemotherapy in non-small-cell lung cancer: Findings from the Florida initiative for quality cancer care
Journal of Oncology Practice
Copyright © 2015 by American Society of Clinical Oncology. Purpose: For patients with resected non-small-cell lung cancer, national guidelines recommend cisplatin-based doublet chemotherapy as the preferred treatment. However, many patients receive a carboplatin-based regimen instead. We aimed to identify factors associated with use of a cisplatin-based regimen and explore its association with other quality-of-care measures. Methods: This analysis was part of the Florida Initiative for Quality Cancer Care, an audit and feedback project among 11 medical oncology practices. Feedback-sharing sessions based on findings of year 2006 took place in 2008. Eligible patients were random samples of those with resected stage I to III non-small-cell lung cancer treated in 2006 and 2009. Results: In both years combined, 81 patients received adjuvant platinum-based doublets: 33 patients (41%) received cisplatin, and 48 patients (59%) received carboplatin. Use of a cisplatin-based doublet significantly increased in 2009 compared with 2006, from 24% to 56% (P = .006). Multivariable analysis determined that academic practices used cisplatin more frequently than nonacademic practices (odds ratios, 3.26; 95% CI, 1.19 to 8.91; P = .02). Moreover, patients treated in 2009 were more likely to receive cisplatin than those treated in 2006 (odds ratio, 4.89; 95% CI, 1.75 to 13.67; P = .002). No significant association between use of cisplatin and other quality-of-care measures was found. Conclusion: In this study, academic practice status and treatment year predicted use of adjuvant cisplatin-based chemotherapy. The increase in use of cisplatin in 2009, as compared with 2006, suggests that audit and feedback may be effective ways to promote such use.
Tanvetyanon, T., Lee, J., Fulp, W., Schreiber, F., Brown, R., Levine, R., Cartwright, T., Abesada-Terk, G., Kim, G., Alemany, C., Faig, D., Sharp, P., Markham, M., Malafa, M., & Jacobsen, P. (2015). Use of adjuvant cisplatin-based versus carboplatin-based chemotherapy in non-small-cell lung cancer: Findings from the Florida initiative for quality cancer care. Journal of Oncology Practice, 11 (4). http://dx.doi.org/10.1200/JOP.2014.001750