Stereotactic Ablative Body Radiotherapy Versus Radical Radiotherapy: Comparing Real-World Outcomes in Stage I Lung...

Area of Science:

• Oncology
• Radiotherapy
• Pulmonary Medicine

Background:

• Stereotactic ablative body radiotherapy (SABR) is the standard of care for medically inoperable stage I non-small cell lung cancer (NSCLC).
• The English National Cancer Registration and Analysis Service (NCRAS) collects comprehensive lung cancer treatment data.

Purpose of the Study:

• To compare outcomes of stage I NSCLC patients treated with SABR versus fractionated radiotherapy.
• To evaluate the survival benefit of SABR in early-stage NSCLC.

Main Methods:

• Utilized NCRAS data for stage I NSCLC patients diagnosed in 2015-2016.
• Linked data to the national Radiotherapy Dataset to identify SABR and fractionated radiotherapy treatments.
• Employed Cox proportional hazards models to compare clinical outcomes.

Main Results:

• 12,384 stage I NSCLC patients identified; 18.6% received radical radiotherapy.
• SABR (69%) demonstrated a survival benefit over fractionated radiotherapy (31%) with a hazard ratio of 0.69.
• Median overall survival was longer with SABR (715 days) compared to fractionated radiotherapy (648 days).

Conclusions:

• SABR provides a significant survival benefit for stage I NSCLC compared to fractionated radiotherapy.
• SABR utilization in England is increasing but lags behind other countries.
• A notable proportion (25%) of stage I NSCLC patients received no active treatment.