Analysis of overall survival and potential prognostic factors among

Abstract

Background: Radiotherapy is an important treatment modality for lung cancer patients of all stages: from high dose curative intended treatment in stage I-III to palliative treatment in stage IV disease. More than 100 patients are treated with potentially curative radiotherapy each year in Region Västra Götaland (VGR), but outcome measures on a population-basis remains to be evaluated. Aim: To evaluate overall survival for lung cancer patients treated with radiotherapy with curative intent in VGR during 2002-2016 and to compare survival depending on time interval, radiation dose, as well as other potential prognostic factors. Methods: Patient and tumor information were retrospectively collected from quality registers, medical records and radiotherapy databases. Patients were analyzed in three groups: stereotactic body radiation therapy (SBRT) for stage I non-small cell lung carcinoma (NSCLC), chemoradiotherapy for locally advanced NSCLC and chemoradiotherapy for small cell lung carcinoma (SCLC). Multivariate survival analyses were performed using the Cox proportional hazards model. Results: 1421 patients were included in the study. Three-year overall survival was 47-55 %, 24-35 % and 20-28 % for the SBRT, locally advanced NSCLC and SCLC groups respectively. There was no significant difference in survival rates between time intervals in any group but trends for improved survival among locally advanced NSCLC patients and declining survival among SCLC patients were observed. Male sex, a poor performance status and NSCLC tumors located in the lower lobe were associated with an inferior survival. Conclusion: The real-life data from this study indicates that overall survival for NSCLC patients in VGR are comparable to previously reported results in clinical trials. A trend for improved survival over time was seen among locally advanced NSCLC patients, albeit not statistically significant. Overall survival for SCLC patients was lower than expected and may also have declined over time.