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Stereotactic body radiotherapy for stage I non-small cell lung cancer.

ABSTRACT: In this manuscript, developments in the techniques, clinical outcome, toxicity, and future perspectives of SBRT for medically inoperable and operable early stage NCSLC are discussed. SBRT is well tolerated and has limited and acceptable side effects. It has evolved as a standard of care for medically inoperable patients. These excellent results taken together with the morbidity and mortality associated with surgery, might also lead to changes in the treatment for operable patients.

SUBMITTER: Slotman BJ

PROVIDER: S-EPMC5658902 | biostudies-literature | 2011

REPOSITORIES: biostudies-literature

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Stereotactic body radiotherapy for stage I non-small cell lung cancer.

Slotman Ben J BJ

Journal of radiosurgery and SBRT 20110101 1

In this manuscript, developments in the techniques, clinical outcome, toxicity, and future perspectives of SBRT for medically inoperable and operable early stage NCSLC are discussed. SBRT is well tolerated and has limited and acceptable side effects. It has evolved as a standard of care for medically inoperable patients. These excellent results taken together with the morbidity and mortality associated with surgery, might also lead to changes in the treatment for operable patients. ...[more]

PMID: 29296299

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Project description:ObjectivesTo compare patterns of care and overall survival (OS) between stereotactic body radiotherapy (SBRT) and percutaneous local tumor ablation (LTA) for non-surgically managed early-stage non-small-cell lung cancer (NSCLC).Materials and methodsThe National Cancer Database (NCDB) was queried from 2004 to 2014 for adults with non-metastatic, node-negative invasive adenocarcinoma or squamous cell carcinoma of the lung with primary tumor size ≤5.0 cm who did not undergo surgery or chemotherapy and received SBRT or LTA. Patterns of care were assessed with multivariate logistic regression. After propensity-score weighting with generalized boosted regression, OS was assessed with univariate and doubly-robust multivariate Cox regression.ResultsOf 15,792 patients, 14,651 (93%) received SBRT and 1141 (7%) received LTA. Increasing age (OR 1.01, p = .035), treatment at an academic institution (OR 2.94, p < .001), increasing tumor size (OR 1.05, p < .001), and more recent year of diagnosis (OR 1.43, p < .001) were predictive of treatment with SBRT, whereas comorbidities (OR 0.74, p = .003) and treatment at a high-volume facility (OR 0.05, p < .001) were predictive for LTA. At a median follow-up of 26.2 months, SBRT was associated with improved OS relative to LTA within a propensity-score weighted doubly-robust multivariate analysis (HR 0.71, p < .001). On weighted subgroup analyses, improved OS was observed with SBRT for tumor sizes >2.0 cm (HR 0.72, p < .001) and for those treated at high-volume facilities (HR 0.71, p < .001). No OS difference was found with SBRT or LTA in tumor sizes ≤2.0 cm (HR 0.90, p = .227).ConclusionWithin the NCDB, SBRT was more commonly utilized and was associated with improved OS when compared to percutaneous LTA for patients with non-surgically managed early-stage NSCLC. Patients with small tumor volumes likely represent an appropriate population for future prospective randomized comparisons between SBRT and LTA.

Dataset Information

Stereotactic body radiotherapy for stage I non-small cell lung cancer.

Publications

Stereotactic body radiotherapy for stage I non-small cell lung cancer.

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