For a study, the researchers sought to look at patterns of failure and the impact of receiving radiation therapy (RT) and chemotherapy to help themselves figure out the best treatment options for the group. Investigators’ institutions identified node-negative NSCLC patients with 5+ cm primary tumors who were receiving definitive RT. The early progression sites were investigated. The cumulative incidence function and Kaplan-Meier analysis were used to look at local progression, regional/distant progression, progression-free survival, and overall survival. Univariable and multivariable competing risk regression was used to investigate associations between local versus regional/distant progression with therapy and clinicopathologic factors. The study group chose 88 patients to study. Initial patterns of failure investigation of individuals with recurrent disease (N=36) revealed that isolated distant (27.8%) and isolated regional progression (22.2%) were the most common. Distant or regional failure was reported in 88.9% of patients who progressed, although isolated local failure was uncommon (11.1%). SBRT was linked to a lower risk of local progression (HR 0.23, P=0.012), while chemotherapy was linked to a lower risk of regional/distant progression (HR 0.12, P=0.040). To summarise, patients with large, node-negative NSCLC who got final RT faced a high risk of regional and distant progression. In this patient cohort, SBRT was linked to a lower probability of local failure, whereas chemotherapy was linked to a lower risk of regional/distant progression. When combined with proper systemic therapy, SBRT may be the best option.
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