NSCLC: post-SABR corticosteroids tied to poorer survival

  • Clin Lung Cancer

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Receiving corticosteroids soon after stereotactic ablative radiotherapy (SABR) for early-stage NSCLC was associated with worse OS, but not recurrence or time to progression (TTP).

Why this matters

  • In the absence of corroborative data, individualized judgment is recommended when administering corticosteroids in this setting.

Study design

  • 912 patients with early-stage NSCLC of T1-3 (satellite lesion), N0, M0, with no metastases, underwent SABR.
  • Funding: NIH; Joan and Herb Kelleher Charitable Foundation.

Key results

  • 87 patients received corticosteroids orally or intravenously within 2 days of SABR.
  • Corticosteroids administered for COPD in 60.9%, chemotherapy in 8.0%, arthritis in 8.0%, chronic pain in 4.6%, transplant-related in 3.4%, and other indications in 14.9%.
  • 58.6% received corticosteroids for ≤2 months, and 41.4% for >2 months.
  • Corticosteroid administration was significantly associated with worse median OS (34.6 vs 58.7 months) and 5-year OS (30.0% vs 49.0%; P<.001 compared with no cs.>
  • No significant difference between groups in TTP or recurrence.
  • Toxicity similar between groups.

Limitations

  • Retrospective, observational design.
  • Findings not generalizable to SABR therapy for larger tumors, patients receiving up-front immunotherapy, or locally advanced disease treated with conventional fractionation.

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