Prospective Cohort Study to Compare Long-Term Lung Cancer-Specific and All-Cause Survival of Clinical Early Stage (T1a-b; ≤20 mm) NSCLC Treated by Stereotactic Body Radiation Therapy and Surgery
Copyright © 2023 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved..
INTRODUCTION: We aimed to compare outcomes of patients with first primary clinical T1a-bN0M0 NSCLC treated with surgery or stereotactic body radiation therapy (SBRT).
METHODS: We identified patients with first primary clinical T1a-bN0M0 NSCLCs on last pretreatment computed tomography treated by surgery or SBRT in the following two prospective cohorts: International Early Lung Cancer Action Program (I-ELCAP) and Initiative for Early Lung Cancer Research on Treatment (IELCART). Lung cancer-specific survival and all-cause survival after diagnosis were compared using Kaplan-Meier analysis. Propensity score matching was used to balance baseline demographics and comorbidities and analyzed using Cox proportional hazards regression.
RESULTS: Of 1115 patients with NSCLC, 1003 had surgery and 112 had SBRT; 525 in I-ELCAP in 1992 to 2021 and 590 in IELCART in 2016 to 2021. Median follow-up was 57.6 months. Ten-year lung cancer-specific survival was not significantly different: 90% (95% confidence interval: 87%-92%) for surgery versus 88% (95% confidence interval: 77%-99%) for SBRT, p = 0.55. Cox regression revealed no significant difference in lung cancer-specific survival for the combined cohorts (p = 0.48) or separately for I-ELCAP (p = 1.00) and IELCART (p = 1.00). Although 10-year all-cause survival was significantly different (75% versus 45%, p < 0.0001), after propensity score matching, all-cause survival using Cox regression was no longer different for the combined cohorts (p = 0.74) or separately for I-ELCAP (p = 1.00) and IELCART (p = 0.62).
CONCLUSIONS: This first prospectively collected cohort analysis of long-term survival of small, early NSCLCs revealed that lung cancer-specific survival was high for both treatments and not significantly different (p = 0.48) and that all-cause survival after propensity matching was not significantly different (p = 0.74). This supports SBRT as an alternative treatment option for small, early NSCLCs which is especially important with their increasing frequency owing to low-dose computed tomography screening. Furthermore, treatment decisions are influenced by many different factors and should be personalized on the basis of the unique circumstances of each patient.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:19 |
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| Enthalten in: |
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer - 19(2024), 3 vom: 08. März, Seite 476-490 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Henschke, Claudia I [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 11.03.2024 Date Revised 11.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jtho.2023.10.002 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM362999767 |
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| 100 | 1 | |a Henschke, Claudia I |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prospective Cohort Study to Compare Long-Term Lung Cancer-Specific and All-Cause Survival of Clinical Early Stage (T1a-b; ≤20 mm) NSCLC Treated by Stereotactic Body Radiation Therapy and Surgery |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 11.03.2024 | ||
| 500 | |a Date Revised 11.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a INTRODUCTION: We aimed to compare outcomes of patients with first primary clinical T1a-bN0M0 NSCLC treated with surgery or stereotactic body radiation therapy (SBRT) | ||
| 520 | |a METHODS: We identified patients with first primary clinical T1a-bN0M0 NSCLCs on last pretreatment computed tomography treated by surgery or SBRT in the following two prospective cohorts: International Early Lung Cancer Action Program (I-ELCAP) and Initiative for Early Lung Cancer Research on Treatment (IELCART). Lung cancer-specific survival and all-cause survival after diagnosis were compared using Kaplan-Meier analysis. Propensity score matching was used to balance baseline demographics and comorbidities and analyzed using Cox proportional hazards regression | ||
| 520 | |a RESULTS: Of 1115 patients with NSCLC, 1003 had surgery and 112 had SBRT; 525 in I-ELCAP in 1992 to 2021 and 590 in IELCART in 2016 to 2021. Median follow-up was 57.6 months. Ten-year lung cancer-specific survival was not significantly different: 90% (95% confidence interval: 87%-92%) for surgery versus 88% (95% confidence interval: 77%-99%) for SBRT, p = 0.55. Cox regression revealed no significant difference in lung cancer-specific survival for the combined cohorts (p = 0.48) or separately for I-ELCAP (p = 1.00) and IELCART (p = 1.00). Although 10-year all-cause survival was significantly different (75% versus 45%, p < 0.0001), after propensity score matching, all-cause survival using Cox regression was no longer different for the combined cohorts (p = 0.74) or separately for I-ELCAP (p = 1.00) and IELCART (p = 0.62) | ||
| 520 | |a CONCLUSIONS: This first prospectively collected cohort analysis of long-term survival of small, early NSCLCs revealed that lung cancer-specific survival was high for both treatments and not significantly different (p = 0.48) and that all-cause survival after propensity matching was not significantly different (p = 0.74). This supports SBRT as an alternative treatment option for small, early NSCLCs which is especially important with their increasing frequency owing to low-dose computed tomography screening. Furthermore, treatment decisions are influenced by many different factors and should be personalized on the basis of the unique circumstances of each patient | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Lung cancer | |
| 650 | 4 | |a Radiation therapy | |
| 650 | 4 | |a Surgery | |
| 650 | 4 | |a Survival | |
| 650 | 4 | |a Treatment | |
| 700 | 1 | |a Yip, Rowena |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Qi |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Pengfei |e verfasserin |4 aut | |
| 700 | 1 | |a Kaufman, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Samstein, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Connery, Cliff |e verfasserin |4 aut | |
| 700 | 1 | |a Kohman, Leslie |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Tannous, Henry |e verfasserin |4 aut | |
| 700 | 1 | |a Yankelevitz, David F |e verfasserin |4 aut | |
| 700 | 1 | |a Taioli, Emanuela |e verfasserin |4 aut | |
| 700 | 1 | |a Rosenzweig, Kenneth |e verfasserin |4 aut | |
| 700 | 1 | |a Flores, Raja M |e verfasserin |4 aut | |
| 700 | 0 | |a I-ELCAP |e verfasserin |4 aut | |
| 700 | 0 | |a IELCART Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Flores, Raja |e investigator |4 oth | |
| 700 | 1 | |a Kaufman, Andrew |e investigator |4 oth | |
| 700 | 1 | |a Lee, Dong-Seok |e investigator |4 oth | |
| 700 | 1 | |a Nicastri, Daniel |e investigator |4 oth | |
| 700 | 1 | |a Wolf, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Song, Kimberly |e investigator |4 oth | |
| 700 | 1 | |a Rosenzweig, Kenneth |e investigator |4 oth | |
| 700 | 1 | |a Gomez, Jorge |e investigator |4 oth | |
| 700 | 1 | |a Samstein, Robert |e investigator |4 oth | |
| 700 | 1 | |a Dutta, Pinaki |e investigator |4 oth | |
| 700 | 1 | |a Beasley, Mary Beth |e investigator |4 oth | |
| 700 | 1 | |a Zakowski, Maureen |e investigator |4 oth | |
| 700 | 1 | |a Chung, Michael |e investigator |4 oth | |
| 700 | 1 | |a Yankelevitz, David F |e investigator |4 oth | |
| 700 | 1 | |a Henschke, Claudia I |e investigator |4 oth | |
| 700 | 1 | |a Taioli, Emanuela |e investigator |4 oth | |
| 700 | 1 | |a Schwartz, Rebecca |e investigator |4 oth | |
| 700 | 1 | |a Chan, Huiwen |e investigator |4 oth | |
| 700 | 1 | |a Zhu, Jeffrey |e investigator |4 oth | |
| 700 | 1 | |a Kantor, Sydney |e investigator |4 oth | |
| 700 | 1 | |a Woode, Sydney |e investigator |4 oth | |
| 700 | 1 | |a Nicastri, Daniel |e investigator |4 oth | |
| 700 | 1 | |a Hakami, Ardeshir |e investigator |4 oth | |
| 700 | 1 | |a Buyuk, Arzu |e investigator |4 oth | |
| 700 | 1 | |a Friedman, Adie |e investigator |4 oth | |
| 700 | 1 | |a Dreifuss, Ronald |e investigator |4 oth | |
| 700 | 1 | |a Verzosa, Stacey |e investigator |4 oth | |
| 700 | 1 | |a Yakubox, Mariya |e investigator |4 oth | |
| 700 | 1 | |a Aloferdova, Karina |e investigator |4 oth | |
| 700 | 1 | |a Stacey, Patricia |e investigator |4 oth | |
| 700 | 1 | |a De Nobrega, Simone |e investigator |4 oth | |
| 700 | 1 | |a Zhu, Jeffrey |e investigator |4 oth | |
| 700 | 1 | |a Kantor, Sydney |e investigator |4 oth | |
| 700 | 1 | |a Woode, Sydney |e investigator |4 oth | |
| 700 | 1 | |a Hakami, Ardeshir |e investigator |4 oth | |
| 700 | 1 | |a Zhu, Jeffrey |e investigator |4 oth | |
| 700 | 1 | |a Kantor, Sydney |e investigator |4 oth | |
| 700 | 1 | |a Woode, Sydney |e investigator |4 oth | |
| 700 | 1 | |a Lentini, Lauren |e investigator |4 oth | |
| 700 | 1 | |a Pass, Harvey |e investigator |4 oth | |
| 700 | 1 | |a Cooper, Benjamin |e investigator |4 oth | |
| 700 | 1 | |a Moreirea, Andre |e investigator |4 oth | |
| 700 | 1 | |a Sorensen, Audrey |e investigator |4 oth | |
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| 700 | 1 | |a Dunton, Robert |e investigator |4 oth | |
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| 700 | 1 | |a Scalzetti, Ernest |e investigator |4 oth | |
| 700 | 1 | |a Ellinwood, Linda |e investigator |4 oth | |
| 700 | 1 | |a Tannous, Henry |e investigator |4 oth | |
| 700 | 1 | |a Connery, Cliff P |e investigator |4 oth | |
| 700 | 1 | |a Torres, Emilo |e investigator |4 oth | |
| 700 | 1 | |a Cruzer, Dan |e investigator |4 oth | |
| 700 | 1 | |a Gendron, Bruce |e investigator |4 oth | |
| 700 | 1 | |a Alyea, Sonya |e investigator |4 oth | |
| 700 | 1 | |a Krumholtz, Pramila |e investigator |4 oth | |
| 700 | 1 | |a Watkins, Ammara |e investigator |4 oth | |
| 700 | 1 | |a Servais, Elliot |e investigator |4 oth | |
| 700 | 1 | |a Stock, Cameron |e investigator |4 oth | |
| 700 | 1 | |a McKee, Andrea |e investigator |4 oth | |
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| 700 | 1 | |a Osa, Etin-Osa |e investigator |4 oth | |
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| 700 | 1 | |a Hyman, Kevin |e investigator |4 oth | |
| 700 | 1 | |a Jurado, Julisa |e investigator |4 oth | |
| 700 | 1 | |a Zeltman, David |e investigator |4 oth | |
| 700 | 1 | |a Glassman, Lawrence |e investigator |4 oth | |
| 700 | 1 | |a Sharma, Rajiv |e investigator |4 oth | |
| 700 | 1 | |a Singh, Vijay |e investigator |4 oth | |
| 700 | 1 | |a Milhelis, Efstathia |e investigator |4 oth | |
| 700 | 1 | |a Karan, Nandanee |e investigator |4 oth | |
| 700 | 1 | |a Rzyman, Witold |e investigator |4 oth | |
| 700 | 1 | |a Dziedzic, Robert |e investigator |4 oth | |
| 700 | 1 | |a Flores, Raja |e investigator |4 oth | |
| 700 | 1 | |a Henschke, Claudia |e investigator |4 oth | |
| 700 | 1 | |a Taioli, Emanuela |e investigator |4 oth | |
| 700 | 1 | |a Yankelevitz, David |e investigator |4 oth | |
| 700 | 1 | |a Schwartz, Rebecca |e investigator |4 oth | |
| 700 | 1 | |a Jirapatnakul, Artit |e investigator |4 oth | |
| 700 | 1 | |a Yip, Rowena |e investigator |4 oth | |
| 700 | 1 | |a Chan, Huiwen |e investigator |4 oth | |
| 700 | 1 | |a Henschke, Claudia I |e investigator |4 oth | |
| 700 | 1 | |a Yankelevitz, David F |e investigator |4 oth | |
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| 700 | 1 | |a Wolf, Andrea |e investigator |4 oth | |
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