Stereotactic radiation therapy offers similar outcomes to lobectomy for stage I NSCLC

  • Lin Q & al.
  • BMC Pulm Med
  • 22 May 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • After controlling for confounders, stereotactic body radiation therapy (SBRT) offered similar outcomes to lobectomy in patients with stage I NSCLC.

Why this matters

  • Treatment options for stage I NSCLC are often limited for elderly patients, poor surgical candidates, and those who decline surgery.

Study design

  • 316 patients with stage I NSCLC received lobectomy (n=246) or SBRT (n=70).
  • Median follow-up was 31.4 months for lobectomy group and 24.9 months for SBRT.
  • Funding: Zhejiang Province.

Key results

  • 3-year local recurrence-free survival (LRFS) rate was not significantly different between groups (97% for lobectomy vs 91.7% for SBRT; P=.768).
  • Before propensity matching, the lobectomy group had a significantly better distant metastasis recurrence-free survival (DMRFS) (86.4% vs 70.8%; P=.011), overall RFS (85.4% vs 69.5%; P=.014), OS (88.2% vs 79.7%; P=.027), and cancer-specific survival (CSS) (91.3% vs 82.5%; P=.022) at 3 years compared with SBRT group.
  • After propensity matching, there was no significant difference between lobectomy and SBRT in LRFS, DMRFS, RFS, OS, or CSS.

Limitations

  • Retrospective, single-center study.