Pattern of treatment and clinico-epidemiological analysis of 804 lung and pleura cancer patients treated in radiation oncology department, NCI-Egypt

BackgroundEpidemiological profile and treatment outcomes of Lung and pleural malignancies vary among different geographical regions. The aim of the study is to analyze the clinico-pathological profile and pattern of treatment of lung and pleural cancers at the Radiation Oncology department, NCI, Cairo University.Materials and methodsA review of 804 clinical patient records with 770 pathologically/cytologically confirmed patients from Jan 2008-December 2012 was performed. Patients were evaluated (clinical, demographic and pathological profiles) in addition to the treatment adopted.ResultsMedian age was 56 years with a male: female ratio of 4:1. Smoking was reported in 63% of patients. Dyspnea and chest pain were the most presenting symptoms (53%). Among lung cancer patients; 78% were NSCLC and 12% SCLC with mesothelioma comprising 10%. Among NSCLCs, adenocarcinoma and large cell undifferentiated carcinoma were the commonest histological subtype (72%). Among NSCLC, 58% cases were of stage IV while among SCLC 73% cases had extensive stage disease. Chemotherapy was administered to 47% (55% vs. 67%, and 35% vs. 31% among non-metastatic lung cancer, mesothelioma patients and metastatic lung cancer and mesothelioma patients respectively). Distant metastases (brain 48%, bone 36%) were reported in 45% of patients. The pattern of treatment intent was palliative (88%) vs. 12% treated with radical intent.ConclusionsAdvanced stages at presentation reflect the palliative pattern of treatment. Hypo-fractionated radiotherapy for lung and pleura malignancies as a palliative measure is the current practice. Implementation of early palliative care should be considered for metastatic patients.