Thermal oblation combined with chemoradiotherapy improves survival rate in intermediate and advanced non-small cell lung cancer：a propensity score matching

Abstract:

Objective：To investigate the clinical efficacy of thermal ablation combined with chemoradiotherapy in the treatment of intermediate and advanced non-small cell lung cancer（NSCLC）. Methods：Based on the surveillance，epidemiology，and end results（SEER） database，51 730 patients with stage Ⅲ/Ⅳ NSCLC who received chemoradiotherapy from 2004 to 2016 were collected. Propensity score matching（PSM） was used to balance the covariate differences between the two groups. Kaplan-Meier curves and log-rank test were used to compare the overall survival（OS） and lung cancer specific survival（LCSS） of the 2 groups. Cox proportional risk model was used to evaluate whether thermal ablation combined with chemoradiotherapy was an independent risk factor for prognosis. Results：After PSM，the thermal ablation combined with chemoradiotherapy group had better 1 year OS（52.11% vs. 45.90%，P=0.017） and 1 year LCSS（54.9% vs. 48.09%，P=0.008） than chemoradiotherapy alone group. When analyzed by subgroup，for patients aged>70 years，the OS and LCSS of thermal ablation combined with chemoradiotherapy group were better than those of chemoradiotherapy alone group before and after the PSM. For patients aged≤70 years，there was a survival benefit，but the difference was not statistically significant. Multivariate analysis showed that tumor size，M stage and treatment were independent prognostic factors for OS and LCSS. Conclusion：For patients with intermediate and advanced NSCLC，thermal ablation combined with chemoradiotherapy may be a potential treatment option，especially for those aged>70 years.