A study titled “Comparative Effectiveness of Stereotactic Body Radiotherapy versus Surgery for Stage I Non-Small-Cell Lung Cancer” and presented at the 56th annual conference of the American Society for Radiation Oncology in San Francisco suggests that patients with early stage non-small cell lung cancer (NSCLC) who don’t suffer from any other diseases, have a more favorable diagnostic over time if they undergo conventional surgery versus less-invasive radiosurgery to remove their cancer.
The research team led by Dr. James B. Yu, assistant professor of therapeutic radiology at Yale School of Medicine and a member of Yale Cancer Center, analyzed Medicare billing records of 1,078 lung cancer patients age 67 and older from across the United States. Based on these registries, they were able to understand the shorter and longer-term complications and outcomes related to surgery versus radiosurgery.
Radiosurgery is usually recommended for the therapy of tumors, vascular lesions, and functional disorders. However, serious clinical judgment must be used with this technique, and considerations must include lesion type, pathology, size, location, age and general health of the patient.
In this type of treatment, there is a selective ionization of the tissue through incidence of high-energy beams of radiation. These ions in turn produce irreparable damage to DNA, proteins and lipids, resulting in the death of tumor cells. However, it also results in the destruction of some healthy tissue as well.
The results from this study demonstrated that treating healthier NSCLC patients with surgery rather than radiosurgery was a more beneficial approach. Moreover, patients who had undergone surgery presented a much better long-term progression when compared to those who were treated with radiosurgery.
“What was dramatic to me was the relatively high rate of complications and death among surgical patients in the first three months compared with how much better they did than radiosurgery patients after 12 months. While surgery may be associated with infections and complications in the short-term, it appears that patients healthy enough to undergo surgery live longer,” Dr. Yu said in a Yale press release.