Association of neoadjuvant radiotherapy with 10-year survival outcomes in large cell lung cancer: A retrospective SEER-based study.

Background

Large cell lung cancer (LCLC) is a distinct subtype of non-small cell lung cancer. Optimizing its treatment is crucial for improving prognosis. Radiotherapy plays an important adjuvant role, yet long-term efficacy data specific to LCLC are limited, and comparisons between neoadjuvant and adjuvant radiotherapy are scarce.

Methods

This study evaluated radiotherapy effectiveness in LCLC and compared survival outcomes between neoadjuvant radiotherapy and adjuvant radiotherapy. Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. After propensity score matching, neoadjuvant and adjuvant radiotherapy cohorts were established. Statistical analyses included survival curves, univariate and multivariate analyses, subgroup analysis, and multiple regression.

Results

The neoadjuvant radiotherapy group showed significantly better overall survival (OS) (P = 0.019) and cancer-specific survival (CSS) (P = 0.036) compared to the adjuvant radiotherapy group. Multivariate regression revealed that, relative to the neoadjuvant group, adjuvant radiotherapy group had increased hazard ratios for OS (HR: 1.2 [1.0-1.4], P = 0.043) and CSS (HR: 1.2 [1.0-1.4], P = 0.036).

Conclusions

Neoadjuvant radiotherapy was associated with improved 10-year survival and may represent a valuable treatment option for patients with LCLC. Further prospective studies are needed to validate these findings.