SBRT Should Be Offered to All Patients With NSCLC Regardless of Comorbidities

Stereotactic body radiotherapy (SBRT) should be offered to all patients with peripheral stage 1 non-small cell lung cancer (NSCLC).
Stereotactic body radiotherapy (SBRT) should be offered to all patients with peripheral stage 1 non-small cell lung cancer (NSCLC).

Stereotactic body radiotherapy (SBRT) should be offered to all patients with peripheral stage 1 non-small cell lung cancer (NSCLC) regardless of their comorbidities, unless performance status and comorbidities prevent accurate SBRT planning and administration.1

SBRT is recommended for patients with medically inoperable patients with peripheral stage 1 NSCLC. Researchers sought to determine if they could reliably predict a subgroup of patients that would not achieve a benefit from SBRT due to short-term expected death.

For the study, which was published in the Journal of Thoracic Oncology, researchers analyzed overall survival data from 779 patients with early stage NSCLC who were treated with Cone Beam CT-guided SBRT in 5 institutes.

Age, gender, ECOG status, operability, FEV1, and Charlson comorbidity index were considered for an association with early death, defined as dying within the first 6 months after treatment.

Results showed that ECOG performance status predicted for early death. Operability was also an important predictor, but to a lesser extent.

Researchers also found that Charlson comorbidity index was associated with overall survival duration.

Investigators determined that for the 10% of patients with the highest risk, the risk of early death was 8.8%, while the risk of early death for the 10% with the lowest risk was 4.1%.

REFERENCE

1. Klement RJ, Belderbos J, Grills I, et al. Prediction of early death in patients with early stage NSCLC – can we select patients without a potential benefit of SBRT as a curative treatment approach? [published online ahead of print April 6, 2016]. J Thorac Oncol. doi:10.1016/j.jtho.2016.03.016.
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