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Improved Survival Outcomes in Medically Fit Patients With Early-Stage Non-Small-Cell Lung Cancer Undergoing
Jason Liu1, Caressa Hui2, Colton Ladbury1
1Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA.
Clinical Lung Cancer
|March 13, 2021
Summary
Patients with early-stage non-small cell lung cancer (NSCLC) who are surgical candidates benefit from stereotactic body radiotherapy (SBRT). Surgical candidacy is associated with improved overall survival (OS) in NSCLC patients treated with SBRT.
Area of Science:
- Oncology
- Radiotherapy
- Surgical Oncology
Background:
- Stereotactic body radiotherapy (SBRT) offers excellent disease control for early-stage non-small cell lung cancer (NSCLC).
- Identifying patient subgroups who most benefit from SBRT in NSCLC is crucial for treatment optimization.
Purpose of the Study:
- To investigate clinical factors associated with overall survival (OS) in early-stage NSCLC patients treated with SBRT.
- To determine if surgical candidacy impacts OS in this patient population.
Main Methods:
- Retrospective analysis of 346 early-stage NSCLC patients treated with SBRT between February 2010 and July 2019.
- Utilized univariate and multivariate analyses, including log-rank tests and Cox proportional hazards regression, to assess associations between clinical factors and OS.
- Primary endpoint was overall survival (OS).
Main Results:
- Surgical candidacy was significantly associated with a decreased likelihood of death (Hazard Ratio 0.360, P = .019) and increased median OS (83 vs 53 months, P = .017).
- Age < 65 years was also associated with a decreased likelihood of death (P = .040).
- Local, locoregional, and distant failure rates were 9.1%, 12.7%, and 10.7%, respectively.
Conclusions:
- Patients with early-stage NSCLC who are candidates for surgery demonstrate improved overall survival when treated with SBRT.
- The findings suggest potential selection bias in comparative studies of surgery versus SBRT for NSCLC, as surgical candidates may have an inherent survival advantage.
