SBRT bests surgery in post-treatment lung cancer survival

Patients with non-small cell lung cancer who underwent stereotactic body radiation therapy (SBRT) had a better post-treatment survival rate than those who received surgery in a new study, published online January 19 in the Journal of Clinical Oncology.

The gold standard for the treatment of early-stage lung cancer has long been surgery. But precisely targeted radiation is emerging as a viable nonsurgical alternative -- especially for older patients who have a high risk of surgical complications.

Researchers from the University of Colorado Cancer Center sought to determine the post-treatment survival rate of patients from the National Cancer Database (NCDB) with non-small cell lung cancer. The dataset included 76,623 patients with non-small cell lung cancer who received surgery and 8,216 patients treated with focused radiation.

The analysis revealed that both forms of treatment resulted in low rates of post-treatment mortality: 2.1% of patients who underwent surgery died within 30 days of treatment compared with 0.7% of patients who received focused radiation.

The gap between the mortality rates of SBRT and surgery widened with age: For patients ages 71 to 75, surgery led to a 1.87% greater risk of mortality compared with SBRT; for patients ages 76 to 80, the difference in risk increased to 2.8%; and for patients older than 80, the difference increased to 3% within 30 days after treatment. This trend also mirrored the measurements taken at 90 days following treatment.

These findings can contribute to the shared decision-making process between patients and providers, particularly for patients at greater risk of early mortality, according to the authors.

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