BACKGROUND: High-level evidence has established well-recognized standard treatment regimens for @entity1 undergoing palliative chest radiotherapy (RT) for stage IV @entity1149 ( @entity1149 ), including treating with fewer than 15 fractions of RT, and not delivering concurrent chemoradiation (CRT) because of its increased @entity137 and limited efficacy in the palliative setting. METHODS: The study included @entity1 in the National @entity5 Database from 2004 to 2012 with @entity5 who received palliative chest radiation therapy. Logistic regression was performed to determine predictors of standard vs nonstandard regimens (>15 fractions or CRT). All statistical tests were two-sided. RESULTS: There were 46 803 @entity1 in the analysis and 49% received radiotherapy for longer than 15 fractions, and 28% received greater than 25 fractions. Approximately 19% received CRT. The strongest independent predictors of long-course RT were private insurance (odds ratio [OR] = 1.40 vs uninsured, 95% confidence interval [CI] = 1.28 to 1.53) and treatment in community @entity5 programs (OR = 1.49, 95% CI = 1.38 to 1.58) compared with academic research programs. The strongest factors that predicted for concurrent chemoradiotherapy were private insurance (OR = 1.38 95% CI = 1.23 to 1.54) compared with uninsured @entity1 and treatment in community @entity5 programs (OR = 1.44, 95% CI = 1.33 to 1.56) compared with academic programs. CONCLUSIONS: Approximately half of all @entity1 with metastatic @entity2 received a higher number of radiation fractions than recommended. @entity1 with private insurance and treated in community @entity5 centers were more likely to receive longer courses of RT or CRT. This demonstrates that a substantial number of @entity1 requiring palliative thoracic radiotherapy are overtreated and further work is necessary to ensure these @entity1 are treated according to evidenced-based guidelines.

Prevalence and Predictors of Inappropriate Delivery of Palliative Thoracic Radiotherapy for Metastatic XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer', 'Cancer', 'stage IV lung cancer'] @entity1149 :: ('MESH:D002289', 'Disease') :: ['NSCLC', 'non-small cell lung cancer'] @entity2 :: ('MESH:D008175', 'Disease') :: ['lung cancer']
@entity2 :: (MESH:D008175,Disease) :: ['Lung Cancer']
