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Conformal radiation therapy improved NSCLC survival
Conformal radiation therapy techniques were associated with improved survival compared with conventional radiation therapy among patients with stage III non–small cell lung cancer, according to study results.
Researchers used the National Cancer Data Base to identify 13,292 patients with American Joint Committee on Cancer stage III NSCLC who underwent chemoradiation therapy between 2003 and 2005. They compared outcomes among patients who underwent conformal radiation therapy — which included 3-D conformal and intensity-modulated radiation therapy — with those who underwent conventional radiation therapy.
Median OS among all patients was 12.9 months. The 3-year OS rate was 19%, and the 5-year OS rate was 11%.
Overall, conformal radiation therapy was significantly associated with improved survival compared with conventional radiation therapy (HR=0.89).
The probability for 3-year OS among patients who received conformal radiation therapy was 22%, compared with 19% for those who underwent conventional radiation therapy (P˂.0001). The probability for 5-year OS also was superior among patients who underwent conformal radiation therapy (14% vs. 11%; P˂.0001).
The survival benefit was comparable between 3-D conformal (HR=0.89) and intensity-modulated (HR=0.87) radiation therapy techniques compared with conventional radiation therapy.
Researchers found conformal radiation therapy significantly improved outcomes on sensitivity analyses that restricted the cohort to patients who achieved at least 6-month survival (HR=0.90; P=.0009) and to patients aged younger than 65 years with stage IIIA disease (HR=0.90; P=.0005).
Results of a propensity-matched cohort analysis that included 3,134 patients demonstrated improved outcomes with conformal vs. conventional radiation therapy (HR=0.89; P=.002).
“Although the slow improvement in outcomes in patients with stage III NSCLC has been predominantly attributed to systemic chemotherapy, the data from the current study argue that more advanced and conformal locoregional therapy also plays an important role in the successful treatment of this difficult disease,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.