Stereotactic radiotherapy a viable option in early-stage lung cancer

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Although health-related quality of life (HRQOL) frequently deteriorates after surgery for stage I non-small-cell lung cancer (NSCLC), a recent study demonstrated that undergoing treatment with stereotactic ablative radiotherapy (SABR) did not seem to have any negative effects on patients with this disease.

Frank J. Lagerwaard, MD, PhD, and colleagues collected HRQOL data on 382 patients with consecutive stage I NSCLC who were treated with SABR. The patients, who had been referred from 68 centers throughout the Netherlands, had either been deemed unfit for surgery (86%) or had declined surgery (14%). Following SABR, they completed questionnaires, providing information on such factors as their level of physical function, appetite loss, pain, and emotional function. This HRQOL data were available for 282, 212, 144, 56, and 43 patients at 3, 6, 12, 18, and 24 months post-SABR, respectively.

The researchers reported in Journal of Thoracic Oncology (2012;7[7]:1148-1154) that median survival was 40 months, with a 2-year survival rate of 66%. Mean global HRQOL score at baseline was 62.9 ± 1.1; baseline symptom scores were highest for dyspnea (47.1 ± 1.7) and fatigue (37.4 ± 1.3).

Except for a nonsignificant reduction of 2 to 3 points per year in physical functioning scores (mean score at baseline was 61.7 ± 1.1), Lagerwaard's team observed no statistically or clinically significant worsening of any of the HRQOL functioning or symptom scores at any point during follow-up. The authors pointed out that this outcome stands in contrast to that seen among patients with stage 1 NSCLC who undergo surgery instead, as the surgical patients often do experience worse HRQOL posttreatment.

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