- Patients with stage IV NSCLC may benefit from combining systemic therapy with surgical resection, external beam radiotherapy (EBRT), or thermal ablation (TA) of the primary tumor site.
Why this matters
- Up to 55% of patients with NSCLC present with stage IV disease; growing evidence supports adding local treatment to systemic therapy for extended survival.
- Researchers analyzed the health records of 34,887 patients with stage IV NSCLC (54.5% men; median age, 68 [interquartile range, 60-75] years).
- They compared OS between the following treatment groups:
- Surgical resection + systemic therapy (n=835);
- EBRT/TA + systemic therapy (n=9539); and
- Systemic therapy alone (n=24,513).
- Funding: US Department of Defense.
- Median follow-up was 39.4 (IQR, 26.6-56.0) months.
- Adding surgical resection was associated with superior OS compared with add-on EBRT/TA (HR, 0.62; P<.001 systemic therapy alone p>
- Adding EBRT/TA significantly improved OS vs systemic therapy alone (HR, 0.95; P=.002).
- EBRT/TA survival benefit was more pronounced among patients with squamous cell NSCLC, T1-T2 N0-N1 disease, and oligometastases (HR, 0.68; P
Retrospective design; lung function, specific systemic therapy protocols, targeted therapies, and exact tumor location/extent not captured.