Better survival for N3 Stage III NSCLC with chemo+radiation

  • Clin Lung Cancer

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Concurrent chemotherapy and radiation (chemo-RT) was associated with a 24% increase in OS compared with chemotherapy alone in patients with N3 stage IIIB NSCLC.
  • The survival benefit remained high, at 21%, for patients aged ≥70 years.

Why this matters

  • Even though the median age of NSCLC diagnosis in the United States is 70 years, people aged ≥70 years only account for about 11% of clinical trials of radiation and chemotherapy regimens for stage III NSCLC.

Study design

  • 9769 patients with N3 stage IIIB NSCLC from the National Cancer Database who received chemo-RT (n=7770) or chemotherapy alone (n=1999).
  • Funding: NIH.

Key results

  • OS was significantly better with chemo-RT vs chemotherapy alone (16.4 vs 12.7 months; P<.0001 even when accounting for patients aged years months p>
  • Chemo-RT was associated with significantly better OS overall (HR, 0.76; 95% CI, 0.71-0.80) and in patients aged ≥70 years (HR, 0.79; 95% CI, 0.73-0.86).
  • Chemo-RT was associated with better OS in patients with adenocarcinoma (HR, 0.79; 95% CI, 0.70-0.90) and squamous cell carcinoma (HR, 0.74; 95% CI, 0.64-0.85), but not large cell carcinoma.

Limitations

  • Retrospective study.

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