Surgical resection is associated with superior 5 - year survival compared to stereotactic body radiotherapy for early - stage lung cancer in healthy patients.
Stereotactic body radiotherapy (SBRT) is being used increasingly in early-stage lungcancer.Between 2012 and 2018, the proportion of otherwise healthy patients treated with SBRTincreased from 15 to 26%.
A study at the Yale University School of Medicinelooked at data fromthe National CancerDatabase forthis six-year periodand compared the 5-yearsurvival rates for patients who hadsurgical resection and patients who elected to have SBRT.Overall,30,658 patients wereidentified, including 24,729 (80.7%) who underwent surgery and 5,929 (19.3%) treated withSBRT.
In propensity-matched patients, survival favored SBRT for the first several months, but reversedafter one year and long-term significantly favored surgical management (5-year survival 71.0%for surgery vs. 41.8% for SBRT).When the propensity-matched analysis was repeated to onlyinclude SBRT patients who had documented refusal of a recommended surgery, surgicalmanagement again had a superior 5-year survival with (71.4% vs. 55.9%).
The increasing usage of SBRT in otherwise healthy individuals represents a potential loss in lifeyears for patients with early-stage NSCLC.Among patients that are eligible for either treatment,long-term survival favors surgical management, particularly for patients with a health-related lifeexpectancy exceeding two years.
Brooks Udelsman, MD,willpresentthis studylooking at some of the reasons patients opt forSBRT,Monday, May 8, at theAmerican Associationfor Thoracic Surgery (AATS)103rdAnnualMeetingin Los Angeles.