Background: Stereotactic ablative body radiation therapy (SBRT) has evolved as the standard treatment for patients with inoperable stage I non–small-cell lung cancer (NSCLC). We report the results of a retrospective analysis conducted on a large, well-controlled cohort of patients with stage I to II NSCLC who underwent lobectomy (LOB) or SBRT. Materials and Methods: One hundred eighty-seven patients with clinical-stage T1a-T2bNoMO NSCLC were treated in 2 academic hospitals between August 2008 and May 2015. Patients underwent LOB or SBRT; those undergoing SBRT were sub-classified as surgical candidates and nonsurgical candidates, according to the presence of surgical contraindications or comorbidities. Results: In univariate analysis, no significant difference was found in local control between patients who underwent SBRT and LOB, with a trend in favor of surgery (hazard ratio [HR], 0.27; 95% confidence interval [CI], 0.07-1.01; P <.053). Univariate analysis showed that overall survival (OS) was significantly better in patients who underwent LOB (HR, 0.44; 95% CI, 0.23-0.85) with a 3-year OS of 73.4% versus 65.2% for surgery and radiation therapy patients, respectively (P <.01). However, no difference in OS was observed between operable patients undergoing SBRT and patients who underwent LOB (HR, 1.68; 95% CI, 0.72-3.90). Progression-free survival was comparable between patients who underwent LOB and SBRT (HR, 0.61; P =.09). Conclusion: SBRT is a valid therapeutic approach in early-stage NSCLC. Furthermore, SBRT seems to be very well-tolerated and might lead to the same optimal locoregional control provided by surgery for patients with either operable or inoperable early-stage NSCLC.

Stereotactic Ablative Radiotherapy as an Alternative to Lobectomy in Patients With Medically Operable Stage I NSCLC: A Retrospective, Multicenter Analysis / Scotti, Vieri; Bruni, Alessio; Francolini, Giulio; Perna, Marco; Vasilyeva, Polina; Loi, Mauro; Simontacchi, Gabriele; Viggiano, Domenico; Lanfranchi, Biancaluisa; Gonfiotti, Alessandro; Topulli, Juljana; Olmetto, Emanuela; Maragna, Virginia; Ferrari, Katia; Bonti, Viola; Comin, Camilla; Balduzzi, Sara; D'Amico, Roberto; Lohr, Frank Reinhard Heinrich; Voltolini, Luca; Livi, Lorenzo. - In: CLINICAL LUNG CANCER. - ISSN 1525-7304. - 20:1(2019), pp. 53-61. [10.1016/j.cllc.2018.09.003]

Stereotactic Ablative Radiotherapy as an Alternative to Lobectomy in Patients With Medically Operable Stage I NSCLC: A Retrospective, Multicenter Analysis

LANFRANCHI, Biancaluisa;Ferrari, Katia;Balduzzi, Sara;D'Amico, Roberto;LOHR, Frank Reinhard Heinrich;
2019

Abstract

Background: Stereotactic ablative body radiation therapy (SBRT) has evolved as the standard treatment for patients with inoperable stage I non–small-cell lung cancer (NSCLC). We report the results of a retrospective analysis conducted on a large, well-controlled cohort of patients with stage I to II NSCLC who underwent lobectomy (LOB) or SBRT. Materials and Methods: One hundred eighty-seven patients with clinical-stage T1a-T2bNoMO NSCLC were treated in 2 academic hospitals between August 2008 and May 2015. Patients underwent LOB or SBRT; those undergoing SBRT were sub-classified as surgical candidates and nonsurgical candidates, according to the presence of surgical contraindications or comorbidities. Results: In univariate analysis, no significant difference was found in local control between patients who underwent SBRT and LOB, with a trend in favor of surgery (hazard ratio [HR], 0.27; 95% confidence interval [CI], 0.07-1.01; P <.053). Univariate analysis showed that overall survival (OS) was significantly better in patients who underwent LOB (HR, 0.44; 95% CI, 0.23-0.85) with a 3-year OS of 73.4% versus 65.2% for surgery and radiation therapy patients, respectively (P <.01). However, no difference in OS was observed between operable patients undergoing SBRT and patients who underwent LOB (HR, 1.68; 95% CI, 0.72-3.90). Progression-free survival was comparable between patients who underwent LOB and SBRT (HR, 0.61; P =.09). Conclusion: SBRT is a valid therapeutic approach in early-stage NSCLC. Furthermore, SBRT seems to be very well-tolerated and might lead to the same optimal locoregional control provided by surgery for patients with either operable or inoperable early-stage NSCLC.
2019
8-set-2018
20
1
53
61
Stereotactic Ablative Radiotherapy as an Alternative to Lobectomy in Patients With Medically Operable Stage I NSCLC: A Retrospective, Multicenter Analysis / Scotti, Vieri; Bruni, Alessio; Francolini, Giulio; Perna, Marco; Vasilyeva, Polina; Loi, Mauro; Simontacchi, Gabriele; Viggiano, Domenico; Lanfranchi, Biancaluisa; Gonfiotti, Alessandro; Topulli, Juljana; Olmetto, Emanuela; Maragna, Virginia; Ferrari, Katia; Bonti, Viola; Comin, Camilla; Balduzzi, Sara; D'Amico, Roberto; Lohr, Frank Reinhard Heinrich; Voltolini, Luca; Livi, Lorenzo. - In: CLINICAL LUNG CANCER. - ISSN 1525-7304. - 20:1(2019), pp. 53-61. [10.1016/j.cllc.2018.09.003]
Scotti, Vieri; Bruni, Alessio; Francolini, Giulio; Perna, Marco; Vasilyeva, Polina; Loi, Mauro; Simontacchi, Gabriele; Viggiano, Domenico; Lanfranchi,...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1172317
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