A comparison between accelerated hypofractionation and stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer (NSCLC): Results of a propensity score-matched analysis

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
Andrew ChiangP Cheung

Abstract

Stereotactic ablative radiotherapy (SABR) has become standard for inoperable early-stage non-small cell lung cancer (NSCLC). However, there is no randomized evidence demonstrating benefit over more fractionated radiotherapy. We compared accelerated hypofractionation (AH) and SABR using a propensity score-matched analysis. From 1997-2007, 119 patients (T1-3N0M0 NSCLC) were treated with AH (48-60 Gy, 12-15 fractions). Prior to SABR, this represented our institutional standard. From 2008-2012, 192 patients (T1-3N0M0 NSCLC) were treated with SABR (48-52 Gy, 4-5 fractions). A total of 114 patients (57 per cohort) were matched (1:1 ratio, caliper: 0.10) using propensity scores. Median follow-up (range) for the AH cohort was 36.3 (2.5-109.1) months, while that for the SABR group was 32.5 (0.3-62.6)months. Three-year overall survival (OS) and local control (LC) rates were 49.5% vs. 72.4% [p=0.024; hazard ratio (HR): 2.33 (1.28, 4.23), p=0.006] and 71.9% vs. 89.3% [p=0.077; HR: 5.56 (1.53, 20.2), p=0.009], respectively. On multivariable analysis, tumour diameter and PET staging were predictive for OS, while the only predictive factor for LC was treatment cohort. OS and LC were improved with SABR, although OS is more closely related to n...Continue Reading

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Citations

Aug 25, 2016·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·N Rodríguez de DiosM Algara
Oct 27, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Jan NymanIngmar Lax
Dec 14, 2018·Cancers·Anoop Haridass
Feb 22, 2021·Seminars in Radiation Oncology·Anna Wrona, Francoise Mornex

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