• Yukinori Matsuo, Fengshi Chen, Masatsugu Hamaji, Atsushi Kawaguchi, Nami Ueki, Yasushi Nagata, Makoto Sonobe, Satoshi Morita, Hiroshi Date, and Masahiro Hiraoka.
• Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Japan. Electronic address: ymatsuo@kuhp.kyoto-u.ac.jp.
• Eur. J. Cancer. 2014 Nov 1; 50 (17): 2932-8.

BackgroundThe aim of this study was to perform a survival comparison between stereotactic body radiotherapy (SBRT) and sublobar resection (SLR) in patients with stage I non-small-cell lung cancer (NSCLC) at high risk for lobectomy.MethodsAll patients who underwent SBRT or SLR because of medical comorbidities for clinical stage I NSCLC were reviewed retrospectively. Propensity score matching (PSM) was performed to reduce selection bias between SLR and SBRT patients based on age, gender, performance status, tumour diameter, forced expiratory volume in 1 second (FEV1) and Charlson comorbidity index (CCI).ResultsOne hundred and fifteen patients who underwent SBRT and 65 SLR were enrolled. The median potential follow-up periods for SBRT and SLR were 6.7 and 5.3 years, respectively. No treatment-related deaths were observed. Before PSM, the 5-year overall survival (OS) was 40.3% and 60.5% for SBRT and SLR, respectively (P=0.008). PSM identified 53 patients from each treatment group with similar characteristics: a median age of 76 years, a performance status of 0-1, a median tumour diameter of ∼20 mm, a median FEV1 of ∼1.8L and a median CCI of 1. The difference in OS became insignificant between the matched pairs (40.4% and 55.6% at 5 years with SBRT and SLR; P=0.124). The cumulative incidence of cause-specific death was comparable between groups (35.3% and 30.3% at 5 years, P=0.427).ConclusionSBRT can be an alternative treatment option to SLR for patients who cannot tolerate lobectomy because of medical comorbidities.Copyright © 2014 Elsevier Ltd. All rights reserved.

31 keywords...

hide…