KEY TAKEAWAYS
- The study aimed to analyze survival data, including local and distant control profiles and cancer- and non-cancer-specific survival, and examine treatment-related side effects.
- LINAC-based SBRT could be a viable alternative to surgery for early-stage NSCLC, especially considering comparable outcomes and favorable side effects.
Arpad Kovacs and his team spearheaded the study to assess LINAC-based SBRT’s viability for early-stage non-small cell lung cancer (NSCLC). The study emphasized analyzing survival data, including local and distant control profiles and cancer- and non-cancer-specific survival. Additionally, they examined treatment-related side effects.
Patients diagnosed with early-stage NSCLC between January 2018 and October 2021 were enrolled. About 77 patients who underwent LINAC-based SBRT were examined. All patients received pretreatment multidisciplinary tumor board recommendations for SBRT. The average age of the patients was 68.8 years (median: 70 years, range: 52-82).
Among them, 70 patients (91%) had an ECOG status of 0, while 7 (9%) had an ECOG status of 1-2. Histological confirmation of NSCLC was present in 52% of patients (40 individuals), with the remaining 48% diagnosed based on PETCT findings. The SBRT regimen consisted of 8 fractions of 7.5 Gy for central tumors (74%) or 4 fractions of 12 Gy for peripheral tumors (26%).
The average follow-up duration was 25.4 months (median 23, range 18-50). Overall survival (OS) estimation via Kaplan-Meier analysis for LINAC-based SBRT patients yielded 41.67 months. Among the 77 patients treated with SBRT, 17 deaths occurred (9 cancer-specific, 8 non-cancer-specific).
The average duration of local tumor control was 34.25 months (range 8.4-41), and systemic control averaged 24.24 months (range 7-25). No Grade I-II adverse events were recorded during treatment. However, 30 cases experienced Grade I non-symptomatic treatment-related lung fibrosis, and two asymptomatic rib fractures were reported.
The study concluded that in early-stage NSCLC treatment, LINAC-based SBRT could serve as a viable alternative to surgery. Despite the patient cohort demonstrating poorer OS compared to literature, attributed to their higher average age and poorer initial general condition (ECOG 1-2), SBRT offers comparable local control, survival outcomes, and favorable side effect profile. Therefore, SBRT may be preferable over surgery in select cases. No funding-related information was available.
Source: https://pubmed.ncbi.nlm.nih.gov/38414671/
Kovács Á, Trási K, Barabás M, et al. (2024) “LINAC-based SBRT in treating early-stage NSCLC patients—single institution experience and survival data analysis.” Pathol. Oncol. Res. 30:1611589. doi: 10.3389/pore.2024.1611589.
