Clinical and economic impact of recurrence in unresected non–small cell lung cancer treated with primary stereotactic body radiotherapy: A real-world study using SEER-Medicare data
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Stereotactic body radiotherapy (SBRT) is the recommended treatment for inoperable, early-stage non-small cell lung cancer (NSCLC). Although prior research has assessed overall survival (OS) and recurrence rates post-SBRT, limited data exist on the clinical and economic impact of recurrence and the association between event-free survival (EFS) and OS in this patient population. OBJECTIVE: To compare OS, health care resource utilization (HRU), and costs between patients with early-stage NSCLC receiving primary SBRT, with and without recurrence, and assess the association between real-world EFS (rwEFS) and OS. METHODS: The SEER-Medicare database (2007-2020) was used to identify patients with stage I-IIB (N0) NSCLC receiving primary SBRT. Patients were categorized into recurrence and nonrecurrence cohorts based on disease recurrence status post-SBRT. OS, all-cause and NSCLC-related HRU, and health care costs were compared between patients with and without recurrence. The correlation between OS and rwEFS was assessed using the normal scores rank correlation and landmark analyses. RESULTS: < 0.0001). CONCLUSIONS: Recurrence after SBRT in unresected, early-stage NSCLC was associated with worse survival and substantial economic burden. The strong correlation between rwEFS and OS suggests that EFS may serve as a good predictor for OS and be a clinically relevant trial endpoint. These findings highlight the need for novel strategies to prevent/delay recurrence.
Authors: Pragya Rai, Andrew Song, Su Zhang, Yan Song, Chi Gao, Anya Jiang, Jiayang Li, Peixi Jiang, James Signorovitch, Ashwini Arunachalam, Ayman Samkari, Megan E. Daly
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4414564205