Using propensity score matching, patients with clinical stage I NSCLC who underwent either VATS lobectomy or stereotactic body radiotherapy (SBRT) were compared for long-term outcomes. Among 37 matched pairs, tumor control at 3 years was twice as good for surgery (p=.0038), cancer-specific survival was 15 percentage points better for surgery (p=.05
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Lung Cancer - Radiation Therapy
VATS Lobectomy Is Associated With Greater Recurrence-Free Survival Than SBRT for Clinical Stage I Lung Cancer
December 14, 2017
June 11, 2016
The author describes the growing role of SBRT in lung cancer therapy and the growing role of radiation oncologists in decision-making regarding lung cancer. The cautionary note is that surgeons need to remain actively involved in staging, patient assessment, and treatment recommendations. Commentary:
June 4, 2016
The authors used data from the NCDB to assess long-term outcomes after SBRT (1,781) or lobectomy (13,562) for clinical stage I NSCLC in patients without important co-morbidities. Overall survival was significantly better after lobectomy for T1N0 (HR 0.38) and for T2N0 patients (HR 0.38). Propensity score matched patients (1781 pairs) also had signi
Treatment Outcomes in Stage I Lung Cancer: A Comparison of Surgery and Stereotactic Body Radiation Therapy
January 23, 2016
Retrospective study of surgery versus SBRT for clinical stage I NSCLC using the National Cancer Data Base (NCDB). Propensity score matching was used to create 5355 matched pairs. In that analysis, median survival for those undergoing surgery was 62.3 months versus 33.1 months in those undergoing SBRT.
December 28, 2015
The goal of this study was to present the changes in pulmonary function after SBRT in 127 patients with clinical stage I NSCLC or a single lung metastasis. These patients were either too high risk for an operation or preferred a non-operative treatment approach.
Treatment Outcomes in Stage I Lung Cancer: A Comparison of Surgery and Stereotactic Body Radiation Therapy (SBRT).
September 20, 2015
A large retrospective study comparing 117618 patients from the National Cancer Database with Stage I NSCLC. 111731 received surgery, 5887 received SBRT. In a propensity managed comparison, those undergoing surgery had increased overall survival.
September 12, 2015
This randomized trial compared induction therapy for pathologically-proven N2/IIIA NSCLC with 3 cycles of cisplatinum and docetaxel chemotherapy alone to chemotherapy combined with 44 Gy of radiation therapy. 232 pts in 23 centers were enrolled over a 12 year period. No differences were identified in the chemotherapy vs chemoradiotherapy groups for
Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomized controlled trials - Part 1 of 9
August 20, 2015
Thus far, only 3 randomized controlled trials (RCTs) have compared stereotactive ablative radiotherapy (SABR) versus surgery in patients with early stage NSCLC (STARS trial, ROSEL trial, and ACOSOG Z4099 trial). Unfortunately all 3 were unable to meet the accrual goals and were closed early.
August 20, 2015
This is an invited commentary on the article by Chang and colleagues (Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials).
Lobectomy versus stereotactic body radiotherapy for stage I non-small cell lung cancer: Post hoc analysis dressed up as level-1 evidence? - Part 3 of 9
August 20, 2015
This expert opinion editorial is published in JTCVS in response to the article by Chang and colleagues. Meyers and colleagues begin by emphasizing that a large randomized controlled trial (RCT) would be the best way to answer the question of whether SABR or lobectomy is superior treatment for patients with early stage NSCLC.