Adjuvant chemotherapy following SBRT for early stage non-small cell lung cancer (NSCLC) in older patients

Adjuvant chemotherapy improves overall survival (OS) following stereotactic body radiotherapy (SBRT) in patients with early stage non-small cell lung cancer and tumors >= four cm. Here, we aim to evaluate its role following SBRT in older patients. Patients >70 years diagnosed with clinical stages I-II NSCLC, (NO disease), who received SBRT, were identified using the National Cancer Database (n - 7042). The Kaplan-Meier method was used to estimate OS, and the log-rank test was used to compare distributions by treatment strategy overall and within clinical stages I and B. There were 3533 female patients (502%), and 6074 (863%) had stage I disease. Among stage! patients, 643 (10.6%) received adjuvant chemotherapy. compared to 372 stage II patients (38.4%). Median OS was better with SBRT in patients with stage I disease (25.4 vs. 20.3 months: p < .001): while patients with stage II NSCLC had better OS with SBRT chemotherapy (20.2 vs. 142 months; p < .001). On multivariate analysis, patients with stage I NSCLC who received SBRT alone had better overall survival (FIR: 0.79; 95% CI, 0.73, 0.87). SBRT alone was associated with an increased risk of death in patients with stage II disease (HR: 1.34; 95% CI, 1.15, 1.55). Patients with tumors cm had better OS with SBRT chemotherapy (185 vs. 15.5 months; p = .003), while patients with tumors >= 4 an did better with SBRT (median OS of 24.1 vs. 20.3 months; p < .001). In >70 years old patients with tumors >= 4 cm, adjuvant chemotherapy following SBRT was associated with improved OS. Published by Elsevier Ltd.