Chemotherapy and Radiation Therapy Completion Rates in Rural Patients With Stage III Lung Cancer: A Focus on Arkansas
DOI:
https://doi.org/10.63501/r20m2z76Keywords:
stage III lung cancer, concurrent chemoradiotherapy, rural disparities, Arkansas, oncology workforce, guideline-concordant care, treatment completionAbstract
Lung cancer remains the leading cause of cancer-related mortality in the United States, with stage III non-small cell lung cancer (NSCLC) presenting a particularly formidable clinical challenge. Concurrent chemoradiotherapy (cCRT) is the standard of care for patients with unresectable stage III NSCLC, yet treatment completion rates are influenced by geographic, socioeconomic, and structural factors that disproportionately affect rural populations. Arkansas, a state characterized by high rurality, elevated smoking prevalence, and significant oncology workforce shortages, exemplifies the intersection of these disparities. This narrative review synthesizes available evidence on chemotherapy and radiation therapy completion rates in rural patients with stage III lung cancer, with particular attention to the Arkansas context. The review draws upon population-based registry data, national cohort analyses, and state-level epidemiological reports to characterize the scope of rural treatment disparities. Findings indicate that rural patients are significantly less likely to receive guideline-concordant treatment for stage III NSCLC, with completion rates reduced by institutional-level resource limitations, provider shortages, transportation barriers, and socioeconomic disadvantage. In Arkansas, where lung cancer incidence ranks among the highest nationally (68.2 per 100,000) and smoking prevalence is second worst in the nation (18.7%), these disparities are compounded by limited access to screening, late-stage diagnosis, and a fragile rural healthcare infrastructure. The review concludes with recommendations for targeted interventions, including tele-oncology expansion, workforce development, and community-based navigation programs, to improve treatment completion and outcomes in rural Arkansas and similarly situated states.
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