Adjuvant chemotherapy improves overall survival (OS) following stereotactic body radiotherapy (SBRT) in patients with early stage non-small cell lung cancer and tumors ≥four cm. Here, we aim to evaluate its role following SBRT in older patients. Patients >70 years diagnosed with clinical stages I-II NSCLC, (N0 disease), who received SBRT, were identified using the National Cancer Database (n = 7042). The Kaplan-Meier method was used to estimate OS, and the log-rank test was used to compare distributions by treatment strategy overall and within clinical stages I and II. There were 3533 female patients (50.2%), and 6074 (86.3%) had stage I disease. Among stage I patients, 643 (10.6%) received adjuvant chemotherapy, compared to 372 stage II patients (38.4%). Median OS was better with SBRT in patients with stage I disease (25.4 vs. 20.3 months; p < .001); while patients with stage II NSCLC had better OS with SBRT + chemotherapy (20.2 vs. 14.2 months; p < .001). On multivariate analysis, patients with stage I NSCLC who received SBRT alone had better overall survival (HR: 0.79; 95% CI, 0.73, 0.87). SBRT alone was associated with an increased risk of death in patients with stage II disease (HR: 1.34; 95% CI, 1.15, 1.55). Patients with tumors ≥4 cm had better OS with SBRT + chemotherapy (18.5 vs. 15.5 months; p = .003), while patients with tumors <4 cm did better with SBRT (median OS of 24.1 vs. 20.3 months; p < .001). In >70 years old patients with tumors ≥4 cm, adjuvant chemotherapy following SBRT was associated with improved OS.

早期非小细胞肺癌和≥4 cm肿瘤患者的立体定向放射治疗（SBRT）后，辅助化疗可改善总体生存（OS）。在此，我们旨在评估SBRT在老年患者中的作用。使用美国国家癌症数据库（n n）对诊断为患有I-II期NSCLC临床分期（N0病）且> 70岁且接受SBRT的患者进行鉴定 = 7042）。Kaplan-Meier方法用于估计OS，对数秩检验用于比较整体和临床I和II期内治疗策略的分布。有3533名女性患者（占50.2％）和6074名患者（占86.3％）患有I期疾病。在I期患者中，有643例（10.6％）接受了辅助化疗，而372例II期患者（38.4％）。I期疾病患者中SBRT的中位OS更好（25.4 vs. 20.3个月；p <.001）; 而II期NSCLC患者接受SBRT +化疗的OS更好（20.2 vs 14.2个月； p <.001）。在多因素分析中，仅接受SBRT的I期NSCLC患者总体生存率更高（HR：0.79； 95％CI，0.73，0.87）。单独使用SBRT会增加II期疾病患者的死亡风险（HR：1.34； 95％CI，1.15，1.55）。≥4 cm肿瘤的患者接受SBRT +化疗的OS更好（18.5 vs. 15.5个月；p  = .003），而肿瘤<4 cm肿瘤的患者接受SBRT +化疗的效果更好（中位OS为24.1 vs. 20.3个月；p  <。 001）。在> 70岁肿瘤≥4cm的患者中，SBRT后的辅助化疗与OS改善相关。