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Radiother Oncol. 2015 Feb;114(2):148-54. doi: 10.1016/j.radonc.2014.12.004. Epub 2015 Jan 10.

Stereotactic body radiotherapy and treatment at a high volume facility is associated with improved survival in patients with inoperable stage I non-small cell lung cancer.

Author information

1
Department of Radiation Oncology, University of Illinois at Chicago, USA; Department of Radiation and Cellular Oncology, The University of Chicago, USA. Electronic address: mkoshy@radonc.uchicago.edu.
2
Department of Radiation and Cellular Oncology, The University of Chicago, USA.
3
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
4
Department of Radiation Oncology, Yale University, USA.
5
Department of Radiation Oncology, Rush University Medical Center, Chicago, USA.

Abstract

BACKGROUND:

This study examined the comparative effectiveness of no treatment (NoTx), conventional fractionated radiotherapy (ConvRT), and stereotactic body radiotherapy (SBRT) in patients with inoperable stage I non-small cell lung cancer. This population based cohort also allowed us to examine what facility level characteristics contributed to improved outcomes.

METHODS:

We included patients in the National Cancer Database from 2003 to 2006 with T1-T2N0M0 inoperable lung cancer (n=13,036). Overall survival (OS) was estimated using Kaplan-Meier methods and Cox proportional hazard regression.

RESULTS:

The median follow up was 68months (interquartile range: 35-83months) in surviving patients. Among the cohort, 52% received NoTx, 41% received ConvRT and 6% received SBRT. The 3-year OS was 28% for NoTx, 36% for ConvRT radiotherapy, and 48% for the SBRT cohort (p<0.0001). On multivariate analysis, the hazard ratio for SBRT and ConvRT were 0.67 and 0.77, respectively, as compared to NoTx (1.0 ref) (p<0.0001). Patients treated at a high volume facility vs. low volume facility had a hazard ratio of 0.94 vs. 1.0 (p=0.01).

CONCLUSIONS:

Patients with early stage inoperable lung cancer treated with SBRT and at a high volume facility had a survival benefit compared to patients treated with ConvRT or NoTx or to those treated at a low volume facility.

KEYWORDS:

Early stage; Lung cancer; Radiation; Stereotactic

PMID:
25586951
DOI:
10.1016/j.radonc.2014.12.004
[Indexed for MEDLINE]

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