Measuring the Integration of Stereotactic Ablative Radiotherapy Plus Surgery for Early-Stage Non-Small Cell Lung...

Area of Science:

• Oncology
• Thoracic Surgery
• Radiation Oncology

Background:

• Surgery is standard for operable early-stage non-small cell lung cancer (NSCLC).
• Stereotactic ablative radiotherapy (SABR) is an alternative for medically inoperable patients.
• The MISSILE trial investigated neoadjuvant SABR followed by surgery for early-stage NSCLC.

Purpose of the Study:

• To evaluate the long-term outcomes of combining neoadjuvant SABR with surgery for early-stage NSCLC.
• To assess the safety and efficacy of this combined treatment approach beyond 5 years.

Main Methods:

• Patients with T1-2N0M0 NSCLC and good performance status were enrolled.
• Neoadjuvant SABR was administered, followed by lobectomy or wedge resection.
• Forty patients received SABR, with 36 proceeding to surgery.

Main Results:

• Pathologic and major complete response rates were 60% and 63%, respectively.
• Five-year overall survival was 66.7%, disease-free survival was 58.3%, and cancer-specific survival was 76.4%.
• Grade ≥3 adverse events occurred in 16.7% of patients, with no grade 5 events.

Conclusions:

• The combination of SABR and surgery is a safe treatment option for early-stage NSCLC.
• This approach demonstrates reasonable long-term clinical outcomes.
• Outcomes were comparable to those of surgery alone.