Predictors of chemoradiotherapy versus single modality therapy and overall survival among patients with unresectable, stage III non-small cell lung cancer

Abstract

Introduction Concurrent chemoradiotherapy (cCRT) was the standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC) prior to the PACIFIC trial, however, patients also received single modality therapy. This study identified predictors of therapy and differences in overall survival (OS). Methods This retrospective study included stage III NSCLC patients aged �65 years, with �1 claim for systemic therapy (ST) or radiotherapy (RT) within 90 days of diagnosis, identified in SEER-Medicare data (2009-2014). Patients who had overlapping claims for chemotherapy and RT �90 days from start of therapy were classified as having received cCRT. Patients who received sequential CRT or surgical resection of tumor were excluded. Predictors of cCRT were analyzed using logistic regression. OS was compared between therapies using adjusted Cox proportional hazards models. Results Of 3,799 patients identified, 21.7% received ST; 26.3% received RT; and 52.0% received cCRT. cCRT patients tended to be younger (p <0.001), White (p = 0.002), and have a good predicted performance status (p<0.001). Patients who saw all three specialist types (medical oncologist, radiation oncologist, and surgeon) had increased odds of receiving cCRT (p<0.001). ST and RT patients had higher mortality risk versus cCRT patients (hazard ratio

The Best Supportive Care in Stage III Non-Small-Cell Lung Cancer

“…A retrospective study with 3799 stage III NSCLC patients analyzed prediction factors associated with the receipt of cCRT. Seeing three types of specialists (medical oncologist, radiation oncologist, and surgeon) prior to the initiation of treatment increased the odds of receiving cCRT compared to seeing only one type of specialist (logistic regression OR 1.87; p < 0.001) [61]. A single-center study evaluated the effectiveness of an MDT approach on the outcomes of 109 patients.…”