Concordance between thoracic multidisciplinary meeting recommendations for radiation therapy and actual treatment for lung cancer

INTRODUCTION: There is limited evidence whether decisions of Thoracic Multidisciplinary Meetings (TMDMs) are reflected in the treatment lung cancer patients actually receive. Aims were to determine concordance between TMDM recommendations for radiotherapy (RT) and actual RT administered and to compare cases that received RT that were referred or not referred from TMDMs. METHOD: A retrospective review of demographic and clinical data for all lung cancer cases within the Auckland-Northland region referred for RT from TMDMs (January-June 2009) and all cases that received RT but were not referred from TMDMs (January-August 2009). RESULTS: Of 110 cases referred for RT from TMDMs, 86 (78%) were offered RT (76 with the same treatment intent) and 78 (71%) received RT. Ten (9%) cases were deemed unsuitable for RT; 7 (6%) deteriorated; 4 (4%) declined or did not attend; 3% other. Fifty-one other cases received RT without TMDM presentation. Cases with remote domicile or recurrent disease were significantly less likely to have been presented at TMDMs. TMDM presentation did not significantly increase transit time to RT. The proportion of RT cases referred from TMDMs had increased substantially since 2004. CONCLUSION: The concordance between TMDM recommendations for RT and both the RT administered and the intent of treatment suggests a useful role for TMDMs. Concordance could be increased by improving RT timeliness and improved education of other disciplines and patients regarding the role of RT. Strategies to increase presentation at TMDM include attention to geographically isolated groups.