A new analysis shows the positive impact of the increased use of stereotactic body radiation therapy to treat patients with stage I non-small cell lung cancer.
Researchers sought to determine whether the increased use of SBRT in recent years had a subsequent impact on the outcomes of patients with NSCLC. Using the Veteran’s Affairs Central Cancer Registry (VACCR), they identified more than 14,000 patients diagnosed with stage I NSCLC from 2001 to 2010, including 3,012 records of patients who received RT as their primary treatment. From this cohort, 468 patients were identified who had SBRT and 1,203 patients who received conventional RT (i.e., the CRT group). Data regarding fractionation, co-morbidities, treatment toxicity, PET utilization and vital status were obtained from the VA Corporate Data Warehouse (VACDW).
Primary outcomes included rates of overall survival (OS) and lung cancer specific survival (LCSS) measured at four years following RT. Researchers computed hazard ratios (HR) to compare OS and LCSS rates and changes in survival rates between the SBRT and CRT groups as well as employed multivariate analysis to assess the influence of participant characteristics on survival outcomes.
The average age of study participants was 72, and 98.6 percent of patients were male. At the time of diagnosis, nearly nine in 10 patients (89.4 percent) were current or former smokers. In terms of disease type, 50.5 percent of patients were diagnosed with stage IA NSCLC, and 41.5 percent were diagnosed with squamous cell carcinoma.
Average survival rates for all patients increased over the study period, as did the use of SBRT. Four year OS for study participants as a whole who underwent radiation rose from 12.7 percent to 28.5 percent and four year LCSS rose from 33.9 percent to 50.4 percent, concurrent with increased utilization of SBRT from 4.7 percent to 60.3 percent.