HealthDay News — Long-term survival favors surgical management over stereotactic body radiotherapy (SBRT) for treatment of early-stage, non-small cell lung cancer (NSCLC), according to a study presented at the annual meeting of the American Association for Thoracic Surgery, held from May 6 to 9 in Los Angeles.
Brooks Udelsman, M.D., from Yale-New Haven Hospital in Connecticut, and colleagues evaluated trends in the utilization of SBRT and the long-term survival for SBRT versus surgery in otherwise healthy patients with early-stage NSCLC. The analysis included 24,729 patients (80.7 percent) who underwent surgery and 5,929 (19.3 percent) treated with SBRT.
The researchers found that between 2012 and 2018, the proportion of patients receiving SBRT increased from 15.9 to 26.0 percent. Increasing age (odds ratio [OR], 1.09) and squamous histology (OR, 1.25) were associated with receiving SBRT. Among patients undergoing surgical resection, the 30-day and 90-day mortality rates were higher versus SBRT (1.7 versus 0.3 percent and 2.8 versus 1.7 percent, respectively). However, among surgically managed patients, the unadjusted five-year survival rate was higher (75.8 versus 40.5 percent). Using data from propensity-matched patients, survival favored SBRT for the first several months but separated after one year and significantly favored surgical management by year 2.
“Among patients that are eligible for either treatment, the long-term survival appears to favor surgical management over SBRT, particularly for patients with a health-related life expectancy [exceeding] two years,” the authors write.