Real-World Patients Management and Referral Patterns in Patients With Stage III Unresectable Non–Small Cell Lung Cancer in Poland

PURPOSE: This multicenter observational study conducted in Poland aims to analyze referral patterns and clinical practice in patients with unresectable stage III non-small cell lung cancer (NSCLC), during the early stage of the national implementation of consolidation immunotherapy, focusing on the use of concurrent chemoradiotherapy (cCRT), sequential chemoradiotherapy (sCRT), and definitive radiotherapy (dRT). MATERIALS AND METHODS: Adult patients with unresectable stage III NSCLC treated with curative-intent radiotherapy between April 1, 2021, and March 31, 2022, were included. Descriptive analyses were performed per the registered protocol. Group comparisons used Fisher's exact test, the chi-squared test, the Kruskal-Wallis test, and Pearson's chi-squared test. RESULTS: Among 273 patients, cCRT and sCRT were administered with equal frequency (37.7% each), followed by dRT (16.5%) and overlapping chemoradiotherapy (8.1%). Groups differed in performance status (PS) and age but not in Union for International Cancer Control-Tumor, Node, Metastasis (UICC-TNM) classification. PS and disease extent influenced the treatment choice. The cCRT was primarily chosen because of the tumor location, whereas sCRT was chosen mainly because of large tumor mass. Complication rates were similar, except for grade 3-4 hematologic toxicity, more frequent with cCRT. CONCLUSION: In Poland, cCRT and sCRT are equally used. Treatment decisions are primarily driven by PS and tumor characteristics rather than UICC-TNM staging.