Early NSCLC: post-SBRT chemotherapy tied to poorer survival

  • Foster CC & al.
  • Lung Cancer
  • 1 Apr 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Adjuvant chemotherapy (ACT) after stereotactic body radiotherapy (SBRT) was associated with worse OS in patients with T1-T3N0M0 NSCLC.
  • Patients with large tumors (≥4 cm) had similar survival with or without post-SBRT ACT.

Why this matters

  • ACT is routinely offered after surgery, but benefit after definitive SBRT is unclear.
  • ACT extends survival after surgery, but not after definitive SBRT, in patients with large tumors. 

Study design

  • 24,011 patients from the National Cancer Database with T1-T3N0M0 NSCLC who received definitive SBRT.
  • Median follow-up 32.5 months.
  • Funding: None.

Key results

  • ACT within 8 weeks of SBRT was received by 1.3% overall and by 3.4% of patients with tumors ≥4 cm (n=2323).
  • ACT was associated with significantly worse OS overall (28.0 vs 36.5 months (aHR, 1.22; P=.005).
  • After propensity matching, ACT was associated with worse OS overall (28.0 vs 47.7 months; HR, 1.60; P<.0001>
  • For tumors ≥4 cm, 3-year OS similar with and without ACT (38.2% vs 33.0%; P=.81).  

Limitations

  • Retrospective study.

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