Changing Patterns of Care for Locally Advanced Non-Small Cell Lung Cancer: Implications for Quality Initiatives

302 Background: Our purpose was to assess the utilization of dose escalated radiotherapy (RT) in Stage III NSCLC patients in the United States from 2004-2013, a period when no Level 1 evidence on dose escalation was published. Methods: Data on all NSCLC patients treated with RT were extracted from the National Oncology Data Alliance (NODA), a pooled database of cancer registries from u003e150 US hospitals. The NODA contains the same data submitted to state cancer registries and SEER, but also contains RT dose fields that are manually verified by trained staff. Search algorithms to identify patients with complete RT dose data and who met the RTOG 0617 eligibility criteria were developed and validated by manual chart review at two institutions. The search algorithm positive predictive values for RT dose and RTOG 0617 eligibility were 97% and 91%, respectively. The primary endpoint was utilization of dose escalated RT, defined as u003e70 Gy. Multivariate logistic regression (MVA) was used to measure the association ...