RSS-Feed abonnieren
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.4103/0971-5851.180138
A cross-sectional observation study regarding patients and their physician willingness to wait for driver mutation report in nonsmall-cell lung cancer
Financial support and sponsorship Nil.![](https://www.thieme-connect.de/media/10.1055-s-00050348/201602/lookinside/thumbnails/10_4103_0971-5851_180138_74-1.jpg)
Abstract
Background: Palliative chemotherapy +/− targeted therapy in accordance with mutation profile is the norm in nonsmall-cell lung cancer (NSCLC). The objective of this audit was to determine the proportion of patients and physicians, who are unwilling to wait for the mutation report and the reasons thereof. Materials and Methods: All newly diagnosed NSCLC patients, post biopsy, seen at our center between November 2014 and January 2015 were included. The relationship between patient and physician decision and objective factors was explored by Fisher's exact test. The factors considered were Eastern Cooperative Oncology Group performance status (ECOG PS), the presence of a cough, hemoptysis, fatigue, and breathlessness. The agreement between patients and physician decision was tested by contingency table. Results: Out of 168 patients, 57 were unwilling to wait for driver mutation report (33.9% 95% confidence interval [CI] 27.2-41.4%). The most common reason provided by patients was symptomatic status (23, 40.1%). No other objective factor except PS (P = 0.00) was associated with patient's decision. In 56 patients (33.4% 95% CI 26.6-40.7%), physicians were unwilling to wait. Among the tested factors ECOG PS (P = 0.000), breathlessness (P = 0.00) and fatigue (P = 0.00) were associated with the decision of not waiting for the report. The percentage corrected value of contingency between patients and physician decision was 78.74%. Conclusion: At present, in our setup, nearly one-third of our NSCLC patients opt for immediate chemotherapy treatment and are unwilling to wait for mutation analysis report. The major reasons for such attitude is poor symptom control and deteriorating general condition.
Keywords
Acceptance - delay - epidermal growth factor receptor mutation analysis - nonsmall-cell lung cancer - willingnessPublikationsverlauf
Artikel online veröffentlicht:
12. Juli 2021
© 2016. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Rivera MP, Mehta AC, Wahidi MM. Establishing the diagnosis of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American college of chest physicians evidence-based clinical practice guidelines. Chest 2013;143 5 Suppl:e142S-65S.
- 2 Reck M, Heigener DF, Mok T, Soria JC, Rabe KF. Management of non-small-cell lung cancer: Recent developments. Lancet 2013;382:709-19.
- 3 Johnson DH, Schiller JH, Bunn PA Jr. Recent clinical advances in lung cancer management. J Clin Oncol 2014;32:973-82.
- 4 Peters S, Adjei AA, Gridelli C, Reck M, Kerr K, Felip E; ESMO Guidelines Working Group. Metastatic non-small-cell lung cancer (NSCLC): ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2012;23 Suppl 7:vii56-64.
- 5 Ettinger DS, Akerley W, Borghaei H, Chang AC, Cheney RT, Chirieac LR, et al . Non-small cell lung cancer, version 2.2013. J Natl Compr Canc Netw 2013;11:645-53.
- 6 Cuffe S, Hon H, Qiu X, Tobros K, Wong CK, De Souza B, et al . Cancer patients acceptance, understanding, and willingness-to-pay for pharmacogenomic testing. Pharmacogenet Genomics 2014;24:348-55.
- 7 Finegold P, Mathieson K, Holmes L, Boon M, Cottle M, Donnai D, et al. Is the UK public ready for genetic medicine? Pers Med 2008;5:65-76.
- 8 ORGI: Census of India Website: Office of the Registrar General & Census Commissioner, India. Website: http://censusindia.gov.in/ [Last accessed on 2015 Apr].