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Comparison of Sublobar Resection and Proton Therapy for Early-Stage Non-small Cell Lung Cancer
Tadashi Sakane1, Koichiro Nakajima2, Hiromitsu Iwata2
1Department of Thoracic Surgery, Nagoya City University West Medical Center, Nagoya, Japan.
Background:
For early-stage lung cancer, sublobar resection (SLR) is an alternative to lobectomy, which is the standard treatment. Recently, proton therapy (PT) is being increasingly used, even in patients with operable lung cancer, as an attractive alternative to conventional radiation therapy. Thus, we performed propensity score matching (PSM) to compare the outcomes of SLR and PT in patients with early-stage non-small cell lung cancer (NSCLC).
Patients And Methods:
A total of 202 patients with histologically confirmed clinical stage 0 or I peripheral NSCLC who underwent SLR or PT at our institution between July 2013 and December 2021 were included in the study. PSM was performed to adjust for confounding effects.
Results:
PSM generated a cohort of 104 patients who were treated with SLR (n = 52) or PT (n = 52). We observed no significant differences in overall survival (OS) (P = .77), cause-specific survival (P = .43), recurrence-free survival (RFS) (P = .35), local tumor control (P = .51), regional lymph node tumor control (P = .99), and distant tumor control (P = .37). The 5-year OS and 5-year RFS were 85.2% and 73.7%, respectively, in the SLR group and 83.4% and 70.2%, respectively, in the PT group.
Conclusion:
This study demonstrated no significant differences in the prognosis or tumor control efficacy between SLR and PT in patients with histologically confirmed clinical stage 0 or I peripheral NSCLC. Further studies are warranted to clarify the comparative effectiveness of SLR and PT across various patient risk strata.
