Hurricane disruption quantified for lung cancer radiotherapy
medwireNews: Hurricane disasters significantly and adversely impact the overall survival (OS) of patients undergoing definitive radiotherapy for locally advanced non-small-cell lung cancer (NSCLC), study findings suggest.
Data from the Federal Emergency Management Agency for 101 hurricane disasters lasting up to 69 days between 2004 and 2014 were used to identify 1734 patients whose treatment was disrupted and a propensity-matched cohort of 1734 individuals whose radiation was not affected.
On average, the hurricane disaster group survived for 29 months versus 31 months for the controls. This translated into 5-year survival estimates of 14.5% versus 15.4%, and a hazard ratio (HR) for death of 1.19 after considering demographic, tumor, and treatment-related factors.
The longer the disaster declaration lasted, the greater the HR for death, increasing up to 1.27 on day 27. Although this correlation was only significant up to day 30, the majority of hurricane declarations were within this duration, say Leticia Nogueira (American Cancer Society, Atlanta, Georgia, USA) and colleagues.
Writing in a letter to JAMA, the team notes that this impact on survival may be partially caused by the increased duration of radiotherapy among the hurricane disaster group, at 66.9 days versus 46.2 days in the controls.
Discussing this potentially preventable factor, they conclude that “[b]ecause no recommended correction for radiotherapy delays exists, strategies for identifying patients, arranging for transferring treatment, and eliminating patient out-of-network insurance charges should be considered in disaster mitigation planning.”
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