von Plessen C et al. - In a study to investigate whether introduction of modern third-generation chemotherapy was associated with survival benefits in pts with advanced non-small cell lung cancer (ANSCLC), and explore geographic and temporary variations of the utilisation of chemotherapy, it seems that utilisation of third-generation chemotherapy was associated with slightly increased survival of pts with ANSCLC Methods
All pts with ANSCLC were included in the national Cancer Registry of Norway
Using sales of vinorelbine as an indicator for third-generation chemotherapy, annual county utilisation rates were calculated
Survival before and after the general introduction of third-generation chemotherapy was compared and associations between survival and variations of chemotherapy utilisation in Norwegian counwere investigated
In a subgroup, survival of pts was compared with and without a registered chemotherapy procedure code and predictors of having received chemotherapy were explored
Results
Of 24,875 pts with lung cancer, 13,757 had ANSCLC
Annual utilisation of the indicator drug increased from 3.7 (1998) to 184.2 grams (2005)
Variations in utilisation across counties diminished threefold during 1999-2005
Median survival increased from 149 to 176 days
Adjusted hazard ratio (HR) for a diagnosis after the introduction of vinorelbine was 0.93
County utilisation rates of vinorelbine were inversely associated with the risk of death
1-year survival with and without chemotherapy was 33.8% and 22.4%; HR = 0.63
County of residence predicted chemotherapy utilisation with odds ratios in the range 0.13 to 1.04
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