Zhong Wangyan, Yuan Hang, Li Ting, Jin Xueying
Department of Radiation Oncology, Shaoxing People' s Hospital, The First Hospital of Shaoxing University, Shaoxing, Zhejiang, PR.China.
Department of Medical Oncology, Shaoxing People' s Hospital, The First Hospital of Shaoxing University, Shaoxing, Zhejiang, PR.China.
PLoS One. 2025 Jul 3;20(7):e0327458. doi: 10.1371/journal.pone.0327458. eCollection 2025.
Currently, optimal treatment regimens for older patients with stage III inoperable NSCLC remain unclear. The aim of this retrospective study was to investigate therapeutic patterns and survival outcomes in older patients with stage III inoperable NSCLC who received radiation therapy (RT) alone or combined with chemotherapy (CT).
A retrospective analysis was conducted on 5740 patients aged ≥65 years with stage III inoperable NSCLC, using data from the Surveillance, Epidemiology, and End Results (SEER) registry (20182021). Patients treated with RT alone (n = 1077) were compared to those receiving RT + CT (n = 4663). Kaplan-Meier analysis and Log-rank tests were performed.
The estimated 3 years overall survival (OS) and cancer-specific survival (CSS) rates were 34.9% and 42.8%, respectively. Median OS and CSS were 21 and 28 months, respectively. Univariate analysis indicated that age, gender, T stage, pathological type and treatment option were independent prognosticators of OS and CSS. Multivariate analysis demonstrated that age, gender, T stage, N stage, and therapeutic strategy were correlated with OS, while gender, T stage, N stage and treatment option were independent prognostic factors for CSS. Subgroup analyses demonstrated that combining RT with CT improved OS in all patient subgroups, and improved CSS in all patients except those at stage N0.
In patients aged ≥65 years with stage III inoperable NSCLC from the SEER database, treatment with RT plus CT provided longer OS and CSS compared to RT alone, except for patients with N0 stage disease.
目前，老年Ⅲ期不可切除非小细胞肺癌（NSCLC）的最佳治疗方案仍不明确。本回顾性研究的目的是调查接受单纯放疗（RT）或联合化疗（CT）的老年Ⅲ期不可切除NSCLC患者的治疗模式和生存结果。
利用监测、流行病学和最终结果（SEER）登记处（2018 - 2021年）的数据，对5740例年龄≥65岁的Ⅲ期不可切除NSCLC患者进行回顾性分析。将单纯接受RT治疗的患者（n = 1077）与接受RT + CT治疗的患者（n = 4663）进行比较。进行了Kaplan - Meier分析和对数秩检验。
估计3年总生存率（OS）和癌症特异性生存率（CSS）分别为34.9%和42.8%。中位OS和CSS分别为21个月和28个月。单因素分析表明，年龄、性别、T分期、病理类型和治疗方案是OS和CSS的独立预后因素。多因素分析表明，年龄、性别、T分期、N分期和治疗策略与OS相关，而性别、T分期、N分期和治疗方案是CSS的独立预后因素。亚组分析表明，RT与CT联合应用可提高所有患者亚组的OS，除N0期患者外，可提高所有患者的CSS。
在SEER数据库中年龄≥65岁的Ⅲ期不可切除NSCLC患者中，与单纯RT相比，RT加CT治疗可提供更长的OS和CSS，但N0期疾病患者除外。
