NSCLC: high-dose SBRT extends survival in stage II disease

  • Lung Cancer

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • A higher biologically effective dose (BED) of stereotactic body radiation therapy (SBRT) offered improved OS in patients with stage II, node-negative (N0) NSCLC, but not node-positive (N1) disease.

Why this matters

  • SBRT has demonstrated survival benefit in stage I NSCLC, but is infrequently used for stage II disease.

Study design

  • 56,543 patients with stage II NSCLC from the National Cancer Database.
  • 19.3-month median follow-up.
  • Funding: None.

Key results

  • 451 patients (0.8%) received SBRT.
  • Of these, 79.8% had N0 and 20.2% had N1 disease.
  • 92.7% of SBRT patients were prescribed BED10≥100 Gy; 28.4% received BED10≥114.9 Gy.
  • Overall, median OS was longer for patients who received BED10≥114.9 Gy vs BED10
  • No significant OS difference between patients who received BED10≥100 Gy vs those who received BED10
  • 30-day mortality after SBRT was similar between groups.
  • An SBRT dose of BED10≥114.9 Gy was associated with better OS (aHR, 0.72; P=.037).
  • Among N0 patents, better survival was associated with increasing BED10 as a continuous variable (aHR, 0.991; P=.0009) and BED10≥114.9 Gy as a dichotomous variable (aHR, 0.63; P=.015).

Limitations

  • Retrospective study.

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