Strengths and limitations of large databases in lung cancer radiation oncology research

The field of radiation oncology has witnessed a substantial increase in the publication of observational analyses using large healthcare databases. These datasets provide investigators with the tools to probe into questions that may not be feasible with prospective studies. The advent of drugs like immune checkpoint inhibitors and newer-generation targeted therapies, as well as enhanced radiotherapy and surgical techniques like intensity-modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT), proton beam therapy, minimally invasive surgery, and robotic-assisted surgery, have led to a need to understand practice patterns, adherence to guidelines, healthcare disparities, and comparative effectiveness