- Stereotactic ablative radiotherapy (SABR) at a biological effective dose (BED) of ≥122 Gy10 was associated with significantly better OS than lower BEDs in early-stage NSCLC with squamous cell carcinoma (SCC) histology.
- Patients with adenocarcinoma (ADC) had no survival benefit from higher-dose SABR.
Why this matters
- SCC is associated with worse local control and OS than ADC after SABR treatment, but dose escalation could mediate that difference.
- 11,084 patients with early-stage NSCLC and SCC (n=4608) or ADC (n=6476) histology from the National Cancer Database who underwent SABR.
- Funding: None.
- After multivariable analysis, BED ≥122 Gy was significantly associated with longer OS, with and without propensity matching for BED, but only in SCC patients (P<.001>
- Propensity-adjusted OS among SCC patients treated with BED ≥122 Gy10 was statistically better than BED 10 at 3 and 5 years (50% vs 44% and 26% vs 22%, respectively; HR, 0.839; P=.009).
- Among SCC patients with tumors ≤3 cm, median OS was significantly better in patients who received BED of 151.2 Gy10 vs those who received BED 100 Gy10 and BED 105.6 Gy10 (39.7 vs 34.9 vs 33.6 months; P=.001).
- Retrospective study.