Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Oct;7(10):5015-5026.
doi: 10.1002/cam4.1776. Epub 2018 Sep 21.

Radiotherapy improves the survival of patients with stage IV NSCLC: A propensity score matched analysis of the SEER database

Rui Zhang  1 , Ping Li  1 , Qin Li  1 , Yunfeng Qiao  1 , Tangpeng Xu  1 , Peng Ruan  1 , Qibin Song  1 , Zhenming Fu  1
Affiliations

Radiotherapy improves the survival of patients with stage IV NSCLC: A propensity score matched analysis of the SEER database

Rui Zhang et al. Cancer Med. 2018 Oct.

Abstract

Objectives: The survival advantage of radiotherapy (RT) for patients with stage IV non-small cell lung cancer (NSCLC) has not been adequately evaluated.

Methods: We analyzed stage IV NSCLC patients enrolled from the Surveillance, Epidemiology, and End Results (SEER) registry through January 2010 to December 2012. Propensity score (PS) analysis with 1:1 nearest neighbor matching method was used to ensure well-balanced characteristics of all comparison groups by histological types and metastatic sites. Kaplan-Meier and Cox proportional hazardous model were used to evaluate the overall survival (OS), cancer-specific survival (CSS), and corresponding 95% confidence interval (95%CI).

Results: Generally speaking, there was a trend toward improved OS and CSS for using RT to stage IV NSCLC patients for any metastatic sites and for any histological types except adenocarcinoma (AD). Radiotherapy significantly improved the survival of NSCLC patients with metastasis to brain (P < 0.001), especially for AD (P < 0.001). For stage IV lung cancer patients with squamous cell carcinoma (SQC), RT for any metastatic sites could universally improve the OS (P < 0.001) and CSS (P < 0.001). In particular, RT was also associated with improving OS (P < 0.001) and CSS (P = 0.012) for stage IV patients with metastases of two or more sites, ie, polymetastatic disease. Furthermore, for those stage IV SQC patients without metastasis, RT, most likely to the primary site, also significantly improved the survival (P < 0.001).

Conclusions: The results support that RT might improve the survival of patients with metastatic NSCLC in a PS-matched patient cohort from the large SEER database. It is prudent to carefully select patients for RT in metastatic NSCLC.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The flowchart of study population selection
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Schiller JH, Harrington D, Belani CP, et al. Comparison of four chemotherapy regimens for advanced non‐small‐cell lung cancer. N Engl J Med. 2002;346(2):92‐98. - PubMed
    1. Cohen MH, Williams GA, Sridhara R, et al. United States food and drug administration drug approval summary: Gefitinib (ZD1839; Iressa) tablets. Clin Cancer Res. 2004;10(4):1212‐1218. - PubMed
    1. Thomas A, Liu SV, Subramaniam DS, Giaccone G. Refining the treatment of NSCLC according to histological and molecular subtypes. Nat Rev Clin Oncol. 2015;12(9):511‐526. - PubMed
    1. He J, Hu Y, Hu M, Li B. Development of PD‐1/PD‐L1 Pathway in Tumor Immune Microenvironment and Treatment for Non‐Small Cell Lung Cancer. Sci Rep. 2015;5(1):13110. - PMC - PubMed
    1. Morgensztern D, Waqar S, Subramanian J, Gao F, Govindan R. Improving survival for stage IV non‐small cell lung cancer: a surveillance, epidemiology, and end results survey from 1990 to 2005. J Thorac Oncol. 2009;4(12):1524‐1529. - PubMed

Publication types