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Chemotherapy and Radiation Versus Chemotherapy Alone for Elderly Patients With N3 Stage IIIB NSCLC.

Abstract：

BACKGROUND:Standard treatment for stage III non-small-cell lung cancer (NSCLC) is concurrent chemotherapy and radiation (chemo-RT). However, N3 stage IIIB disease portends a worse prognosis and the tolerability of chemo-RT in patients ≥70 years old is a concern. In this analysis, we evaluate the survival of patients with N3 stage IIIB NSCLC who were treated with chemo-RT or chemotherapy alone with a focus on elderly patients. PATIENTS AND METHODS:We retrospectively analyzed patients diagnosed with N3 stage IIIB NSCLC between 2010 and 2013 using the National Cancer Database. We compared overall survival (OS) between patients who underwent chemo-RT versus chemotherapy alone. The Kaplan-Meier method was used for median OS with log rank tests. Multivariable Cox models were used for multivariable and subgroup analyses. RESULTS:We included 9769 patients in our analysis, 7770 of whom received chemo-RT and 1999 who received chemotherapy alone. The median OS for patients who received chemo-RT was 16.4 months versus 12.7 months with chemotherapy alone (P < .0001). The median OS for patients ≥70 years old who received chemo-RT was 15.0 months versus 12.4 months with chemotherapy alone (P < .0001). In multivariable analyses, the benefit of chemo-RT was similar regardless of age. Subgroup analyses in patients ≥70 years indicated a benefit of chemo-RT (hazard ratio, <1.0) across all patient and disease strata. CONCLUSION:Survival was improved in elderly patients who received chemo-RT versus chemotherapy alone for N3 stage IIIB NSCLC. Our findings suggest that age and comorbidities should not preclude clinicians from recommending chemo-RT to these patients.

journal_name

Clin Lung Cancer

journal_title

Clinical lung cancer

authors

Qin A,Lusk E,Daignault-Newton S,Schneider BJ

doi

10.1016/j.cllc.2019.04.003

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

e495-e503

issue

4

eissn

1525-7304

issn

1938-0690

pii

S1525-7304(19)30083-X

journal_volume

20

pub_type

杂志文章

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