Stereotactic ablative body radiotherapy versus conventionally fractionated radiotherapy for early stage large cell neuroendocrine carcinoma of the lung

AIM: Some patients with early stage large cell neuroendocrine carcinoma (LCNEC) of the lung are not surgical candidates and will be managed with radiotherapy. We used the national cancer database to identify predictors of stereotactic radiotherapy and compare outcomes. MATERIALS & METHODS: We queried national cancer database for T1-2N0 LCNEC treated with radiation. Logistic regression and Cox regression identified predictors of stereotactic ablative body radiotherapy (SABR) and survival, respectively. RESULTS: We identified 754 patients, with 238 (32%) treated with SABR. Predictors of SABR were distance to facility, no chemotherapy, academic center, T1 and recent year. After propensity matching, median survival was 34.7 months compared with 23.7 months in favor of SABR (p = 0.02). CONCLUSION: SABR for LCNEC has increased over time and was associated with improved survival.