Stereotactic radiotherapy safe for people with lung cancer and COPD

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Compared with surgery, stereotactic body radiotherapy (SBRT) is an effective treatment option for people with stage 1 non-small-cell lung cancer (NSCLC) who also have chronic obstructive pulmonary disease (COPD), according to the results of a recent study.

COPD, which can increase the risk of postoperative complications for people with lung cancer, is present in approximately 50% to 70% of such patients at the time of their cancer diagnosis, according to a statement from the American Society of Radiation Oncology (ASTRO) announcing the results of the study. In that project, a team led by radiation oncologist David Palma, MD, MSc, of the London Regional Cancer Program in London, Ontario, Canada, evaluated a single-institution cohort of 176 patients with severe COPD and stage 1 NSCLC who underwent SBRT. The researchers then conducted a systematic review of studies reporting outcomes after SBRT or surgery for patients with severe COPD and stage 1 NSCLC.

As they reported in International Journal of Radiation Oncology, Biology, Physics (2012;82[3]:1149-1156), Palma and colleagues found a mean 30-day mortality rate of 0% following SBRT, compared with 10% following surgery. Overall survival rates for the two interventions were deemed comparable by the investigators:

  • 1 year post-SBRT: 79%-95%
  • 1 year post-surgery: 45%-86%
  • 3 years post-SBRT: 43%-70%
  • 3 years post-surgery: 31%-66%.

After describing SBRT as safe, effective, and less invasive than surgery in the ASTRO statement, Palmer recommended that all eligible patients be evaluated in a multidisciplinary setting and afforded an informed decision of the risks and benefits of both surgery and SBRT.

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