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Radiation Therapy for NSCLC: Are There Racial Differences in Treatments and Side Effects?

By: Julia Fiederlein
Posted: Monday, May 9, 2022

A multi-institutional analysis, which was published in JCO Oncology Practice, did not provide evidence of racial differences in radiation therapy or chemotherapy approaches in patients with non–small cell lung cancer (NSCLC). According to Shruti Jolly, MD, of the University of Michigan, Ann Arbor, and colleagues, this finding delivers valuable insight into the care of racially diverse populations.

“This represents encouraging progress from a historical era during which lower rates of surgery in Black patients with lung cancer resulted in lower rates of survival,” the investigators commented. “However, the findings from this study that warrant further research include possible underrecognition of Black patients’ symptoms, particularly with regards to treatment-related esophagitis.”

Using a large institutional review board–approved statewide patient-level database, the investigators identified 1,441 patients with stage II to III NSCLC who underwent definitive thoracic radiation therapy between March 2012 and November 2019. In terms of racial representation, 80% were White, 16% were Black, and 4% were another race.

In this population, race did not seem to be significantly associated with the radiation therapy or chemotherapy approach. Compared with White patients, the rates of general pain appeared to be significantly higher in Black patients at baseline and after radiation therapy. Black patients were found to be significantly less likely to experience provider-reported pneumonitis of grade 2 or higher (odds ratio = 0.36; P = .03); this finding seemed to hold true after controlling for known patient and treatment factors. The correlation coefficients between provider- and patient-reported toxicities did not appear to differ across race groups; however, a stronger correlation between patient- and provider-reported esophagitis was observed in White patients.

Disclosure: For full disclosures of the study authors, visit ascopubs.org.


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