The effect of radiotherapy and surgery on stage IIIA/B NSCLC patients treated with chemotherapy

Background: The combination of radiotherapy and surgery is used to treat locally advanced non-small cell lung cancer (NSCLC). The aim of this study was to analyze IIIA/ B NSCLC patients treated with chemotherapy from the Surveillance, Epidemiology, and End Results (SEER) database to clarify whether patient prognosis correlated with surgery and radiotherapy. Materials and Methods: The IIIA/B NSCLC patients were selected from the SEER database and classified into IIIA (N0-1), IIIA (N2), IIIB (N2), and IIIB (N3). Cox analyses and Kaplan-Meier method were used to estimate the prognostic factors and lung cancer specific survival (LCSS) curves. Results: We divided 7933 cases into IIIA (N0-1), IIIA (N2), IIIB (N2), and IIIB (N3). Cox regression showed that age, sex, primary site, grade, treatment, T stage, and marriage were independent risk factors for IIIA (N0-1); age, sex, treatment, and T stage had prognostic significance for IIIA (N2); age, sex, primary site, grade, treatment, and T stage were prognostic factors for IIIB (N2); and age and primary site had effect on the prognosis of IIIB(N3). The effect of chemotherapy-surgery was better than that of chemotherapy preoperative radiotherapy-surgery and chemotherapy-surgery-postoperative radiotherapy for IIIA (N0-1). In IIIA (N2) and IIIB, radiotherapy did not improve the LCSS. Conclusion: Surgery offered more survival benefits for IIIA (N0-1) patients. Radiotherapy did not improve the LCSS of IIIA (N2) and IIIB patients.