2319 - Survival Disparities in Lung Cancer Based on Tumor Staging and Demographics in a Third World Country Radiation Therapy Cohort
Presenter(s)
L. B. Assuncao1, T. R. Dias1, M. L. T. Bento1, J. S. Pavão1, R. A. B. Aguiar1, G. L. F. Cunha1, R. Ferrari2, G. Barbosa3, E. Fuks4, L. Oliveira5, P. Canary6, C. Almeida7, J. Melo8, and D. Przybysz6; 11. RadioSerra Radiation Therapy 2. Petropolis Medical School - FMP, Petrópolis, Brazil, 2RadioSerra, Petrópolis, Rio de Jan, Brazil, 3Radioserra Radiation Therapy, Petrópolis, Brazil, 4Radioserra Radiation Therapy, Petrópolis, RJ, Brazil, 51. RadioSerra Radiation Therapy, Petrópolis, Brazil, 6RadioSerra Radiation Therapy, Sao Paulo, Sao Paulo, Brazil, 7Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil, 81.CTO e 2.RadioSerra Radiation Therapy, Petrópolis, Brazil
Purpose/Objective(s): Real-world data on lung cancer survival outcomes in Latin America remain limited, particularly regarding how tumor stage and patient demographics influence survival in radiotherapy-treated populations. Most survival benchmarks come from North American and European cohorts, where access to systemic therapies and radiotherapy differs. This study aims to analyze real-world survival outcomes of lung cancer patients treated with radiotherapy in Brazil, evaluating the independent impact of tumor stage and age on overall survival (OS).
Materials/Methods: A retrospective, real-world cohort study was conducted on 209 lung cancer patients treated with radiotherapy at a Brazilian institution between 2020 and 2025. Patients were stratified by tumor stage (I-IV) and age group (=70 vs. >70 years). The primary endpoint was OS, analyzed using Kaplan-Meier survival curves. A multivariate logistic regression model was used to assess the independent effects of tumor stage and age on survival outcomes. Statistical significance was set at p<0.05. Comparative analysis was performed against published survival benchmarks from North America and Europe to contextualize findings within global treatment standards.
Results: The cohort comprised 209 patients, with 36.4% aged >70 years. Median OS was 28 months for Stage III and 16 months for Stage IV. Patients >70 showed a 20% reduction in OS compared to younger patients, independent of tumor stage (HR=1.20, 95% CI, p=0.03). Multivariate Cox analysis confirmed both advanced tumor stage (Stage IV vs. Stage III; HR=X, p<X) and age >70 years (HR=1.20, p=0.03) as independent predictors of decreased OS. Survival outcomes in this Brazilian cohort were consistent with European benchmarks (~30% two-year OS for Stage III-IV) but lower than those observed in North America (~40-50% two-year OS). These differences likely reflect regional disparities in early detection, access to advanced systemic therapies (including targeted agents and immunotherapy), and radiotherapy techniques.
Conclusion: This study represents the first real-world survival analysis of lung cancer patients receiving radiotherapy in a Brazilian cohort, highlighting that survival outcomes align more with Europe data than North America, particularly for advanced-stage disease. Our findings reveal that survival outcomes parallel European data but fall short of North American standards, particularly in advanced disease stages. Age >70 significantly exacerbated survival disparities, underscoring the necessity for age-specific management strategies and broader access to novel systemic treatments. This study highlights critical regional disparities and the need for targeted healthcare policies and further research into the barriers impacting lung cancer survival in Latin America.