Radiation Not Tied to Improved Survival in Advanced NSCLC

Postoperative radiation confers no survival benefit for elderly with N2 non-small-cell lung cancer

MONDAY, Feb. 13 (HealthDay News) -- Postoperative radiation therapy (PORT) is not associated with improved survival for elderly patients with N2 non-small-cell lung cancer (NSCLC), according to a study published online Feb. 13 in Cancer.

Juan P. Wisnivesky, M.D., Dr.Ph., of the Mount Sinai School of Medicine in New York City, and colleagues used data from the Surveillance, Epidemiology, and End Results (SEER) registry linked to Medicare records to identify 1,307 patients who had stage III NSCLC with N2 lymph node involvement, diagnosed between 1992 and 2005. Survival of patients who did and did not receive PORT was compared used propensity scoring methods and instrumental variable analysis.

The researchers found that 710 patients (54 percent) were treated with PORT. PORT was not associated with improved survival in patients with N2 disease (hazard ratio, 1.11; 95 percent confidence interval, 0.97 to 1.27), based on propensity score analysis. Similar results were seen on restricting analyses to patients who did or did not receive chemotherapy and patients who received intermediate-complexity or high-complexity radiotherapy. Additionally, similar results were found when analyses were repeated adjusting for time trends in the use of other lung cancer treatments. The absolute improvement in one-year and three-year survival with PORT was −0.04 and −0.08, respectively, based on the instrumental variable estimator.

"The current data suggested that PORT is not associated with improved survival for elderly patients with N2 disease. These findings have important clinical implications, because SEER data indicate that a large percentage of elderly patients currently receive PORT despite the lack of definitive evidence about its effectiveness," the authors write.

One author disclosed financial ties to pharmaceutical companies.

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