Lobectomy vs Stereotactic Body Radiation Therapy in Non-Small Cell Lung Cancer

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Immediate post-procedural mortality was higher in the surgery groups than the SBRT group in unadjusted analysis.
Immediate post-procedural mortality was higher in the surgery groups than the SBRT group in unadjusted analysis.

HealthDay News — For stage I non-small-cell lung cancer, survival is better with lobectomy than stereotactic body radiation therapy (SBRT), although there is no difference for sublobar resection and SBRT, according to a study published in the Annals of Thoracic Surgery.

Alex K. Bryant, from the University of California San Diego in La Jolla, and colleagues compared cancer-specific survival among patients with biopsy-proven clinical stage I non-small-cell lung cancer receiving lobectomy, sublobar resection, or SBRT. Data were included for 4069 patients (449 SBRT, 2986 lobectomy, and 634 sublobar resection).

The researchers found that immediate post-procedural mortality was higher in the surgery groups than the SBRT group in unadjusted analysis. 

After adjustment for confounders, including preoperative pulmonary function, smoking status, comorbidity, and staging work-up procedures, the analysis considering long-term survival found higher cancer-specific mortality for SBRT than lobectomy (subdistribution hazard ratio, 1.45; 95% CI, 1.09 to 1.94; P =.01), but no significant difference between SBRT and sublobar resection (subdistribution hazard ratio, 1.25; 95% CI, 0.93 to 1.68; P =.15).

"Among a large cohort of early-stage lung cancer patients, we found that lobectomy had improved survival compared with SBRT, although we found no survival difference between sublobar resection and SBRT," the authors write.

Reference

Bryant AK, Mundt RC, Sandhu AP. Stereotactic body radiation therapy vs surgery for early lung cancer among US veterans. Ann Thorac Surg. 2017 Nov 21. pii: S0003-4975(17)31099-8.

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