High-dose SABR offers survival advantage in lung SCC

  • Lung Cancer

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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).

Limitations

  • Retrospective study.