Adverse Events Following Limited Resection versus Stereotactic Body Radiation Therapy for Early Stage Lung Cancer

Area of Science:

• Pulmonology
• Oncology
• Radiation Oncology

Background:

• Limited resection and stereotactic body radiation therapy (SBRT) are alternatives for early-stage lung cancer patients unfit for lobectomy.
• Adverse events (AEs) significantly influence treatment decisions and outcomes when effectiveness is comparable.

Purpose of the Study:

• To compare the adverse event (AE) profiles of SBRT versus limited resection in high-risk lung cancer patients.
• To inform patient decision-making by detailing the toxicity differences between these two treatment modalities.

Main Methods:

• Prospective cohort study of 252 patients with stage I-IIA non-small cell lung cancer.
• Used propensity score analysis and inverse probability weighting to compare 30- and 90-day AEs between SBRT and limited resection groups.

Main Results:

• No significant difference in the overall rate of at least one AE between SBRT and limited resection at 30 and 90 days.
• SBRT was associated with significantly lower infectious and respiratory AEs compared to limited resection.
• SBRT demonstrated a persistently higher risk of fatigue up to 90 days post-treatment.

Conclusions:

• SBRT and limited resection show comparable overall AE rates for high-risk lung cancer patients.
• SBRT offers a toxicity advantage regarding infectious and respiratory complications but is linked to increased fatigue.
• These AE findings, alongside oncologic outcomes, are crucial for shared decision-making in lung cancer treatment selection.