Improving Treatment Outcome of Radiation Therapy in Non-small Cell Lung Cancer (NSCLC): Results of 288670 Patients from SEER-17 Database

Purpose/Objective(s): There have been remarkable advances in radiation technology in treatment of non-small cell lung cancer (NSCLC) recently. It is well known that radiation provides local tumor control and technology matters. This study aimed to examine whether 1) radiation can improve survival over other nonsurgical treatment and 2) the survival during the recent years with advancement of technology.Materials/Methods: The study population includes all 1st primary NSCLC from the SEER-17 database 1999-2008. The data were stratified by AJCC stage and treatment type (surgery only, surgery + radiation, radiation only, neither surgery nor radiation and unknown treatment). Chemotherapy data were not available in the SEER-17 data. Frequency distributions and percentages by strata were analyzed. Median Survival times with associated 95% confidence intervals (95%CIs) were estimated by the Kaplan-Meier method. Data are presented as median survival time (in month) (95%CI). The “na” refers to an interval that was too narrow to be computable.Results: A total of 288670 patients included in this analysis. The stage distribution was as following: 19% stage I, 4% stage II, 26% stage III, 46% stage IV and 11% unknown. The median survival was 49 (48-50), 27 (26-29), 9 (9-10), 4 (na) and 7 (6-8) months, for stage I, II, III, IV and unknown, respectively. Overall, 78% were treated with non-surgical modality; only 32% received radiation treatment. In patients who did not have surgery, treatment of radiation generated a significant better survival in each stage: stage I 18 (18-19) vs 12 (11-12) months (P<0.05), 15 (14-15) vs 7 (7-9) months P<0.05), 11 (na) vs 5 (na) months (P<0.05), and 12 (na) months vs 4 (na) months, and 5 (na) vs 3 (na) months, for stage I, II, III, IV and unknown, respectively. In those treated with radiation, the median survival improved significantly during recent years (2004-2008) compared to that of earlier years (1999-2003) in stage I (6 months’ extension) and III (3 months’ extension), but not stage II and IV (no changes).Conclusion: In patients with unresectable inoperable disease, radiation therapy extended median survival in all stages of NSCLC in these 288670 patients of SEER data base. Superior survival in patients of stage I and III treated during the recent years suggests a potential benefit from the advanced technology.

MSRO22-06

Improving Treatment Outcome of Radiation Therapy in Non-small Cell Lung Cancer (NSCLC): Results of 288670 Patients from SEER-17 Database