In a new study entitled “Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials” researchers at The University of Texas MD Anderson Cancer Center argue that patients with operable stage I non-small cell lung cancer have increased chances of survival if treated with Stereotactic Ablative Radiotherapy (SABR), when compared to current treatment strategy, invasive surgery. The study was published in the journal The Lancet Oncology.
Patients with inoperable non-small cell lung cancer (NSCLC) treated with Stereotactic Ablative Radiotherapy (SABR), a method where patients receive radiotherapy from many different positions around the body, had better outcomes when compared to traditional radiotherapy. However, because of the risk of recurrence after SABR, patients with operable NSCLC are submitted to lung surgery – lobectomy (removal of half of a lung) – in the hopes it can prevent cancer recurrence.
In this study researchers at The University of Texas MD Anderson Cancer Center followed 58 patients who were randomly assigned to receive either SABR (31 patients) or lung surgery (27 patients). The team measured patients’ overall survival, recurrence and toxicity. They observed that patients submitted to SABR exhibited a significantly higher three-year survival rate, when compared to the surgery group – specifically, 95% versus a 79%, respectively. The recurrence-free survival rate was of 80% in the surgery group and 86% in SABR patients. While 6 patients in the surgery group died, there was only one registered death in the SABR group. Moreover, patients treated with SABR had no signs of high-grade toxicity.
Thus, these findings suggest SABR is an effective and safe non-invasive alternative for NSCLC patients, particularly in the elderly and those with significant comorbidities.
Joe Y. Chang, M.D., Ph.D., professor, Radiation Oncology and study first author commented, “For the first time, we can say that the two therapies are at least equally effective, and that SABR appears to be better tolerated and might lead to better survival outcomes for these patients. Stereotactic radiation treatment is a relatively new approach for operable early stage lung cancer, while surgery has been the standard for a century. This study can give physicians confidence to consider a non-invasive option.”
Jack A. Roth, M.D., Professor and Bud Johnson Clinical Distinguished Chair Department of Thoracic & Cardiovascular Surgery and study lead author added, “The findings of our study provide strong support for a large clinical trial to investigate the potential superiority of SABR for patients with early-stage disease. While we wait for more data, physicians can consider SABR an effective treatment for these patients, especially for those whom surgery brings high risk.”