NEW YORK – For the estimated one-fourth of early-stage lung cancer patients not medically fit for lobectomy, limited resection and stereotactic body radiation therapy (SBRT) are seen as alternative treatments.
“Given the equipoise on the effectiveness of the two treatments, treatment-related adverse events (AEs) could have a significant impact on patients’ decision-making and treatment outcomes,” wrote the authors of a new study in the Annals of the American Thoracic Society.”
Researchers from the Icahn School of Medicine and colleagues from other medical institutions, including the VA Portland Health Care System, sought to compare the adverse effects profile between SBRT vs. limited resection.
To do that, the study team derived data from a prospective cohort of stage I-IIA non-small cell lung cancer patients who were deemed as high-risk for lobectomy recruited from 5 centers across the United States.
The researchers used propensity scores and inverse probability weighting to compare the rates of 30- and 90-day AEs among patients treated with limited resection vs. SBRT. Overall, 65% of 252 patients underwent SBRT, the article noted.
Results indicated that, after adjusting for propensity scores, no significant difference in developing at least one AE comparing SBRT to limited resection (odds ratio [OR]: 1.00; 95% confidence interval [CI]: 0.65-1.55 and OR: 1.27; 95% CI: 0.84-1.91 at 30 and 90 days, respectively) was identified.
The authors pointed out, however, that SBRT was associated with a lower risk of infectious AEs than limited resection at 30 days (OR: 0.05; 95% CI: 0.01-0.39) and 90 days post-treatment (OR: 0.41; 95% CI: 0.17-0.98).
“Additionally, SBRT was associated with a persistently elevated risk of fatigue (OR: 2.47; 95% CI: 1.34-4.54 at 30 days and OR: 2.69; 95% CI: 1.52-4.77 at 90 days, respectively), but significantly lower risks of respiratory AEs (OR: 0.36; 95% CI: 0.20-0.65 and OR: 0.51; 95% CI: 0.31-0.86 at 30 and 90 days, respectively),” they added.
Researchers concluded, overall, that SBRT is associated with “less toxicity than limited resection in terms of infectious and respiratory AEs but higher rates of fatigue that persisted up to 3 months post-treatment. This information, combined with data about oncologic effectiveness, can help patients’ decision-making regarding these alternative therapies.”
1. Wang Q, Stone K, Kern JA, Slatore CG, Swanson S, Blackstock W Jr, Khan RS, Smith CB, Veluswamy RR, Chidel M, Wisnivesky JP. Adverse Events Following Limited Resection versus Stereotactic Body Radiation Therapy for Early-Stage Lung Cancer. Ann Am Thorac Soc. 2022 Jul 11. doi: 10.1513/AnnalsATS.202203-275OC. Epub ahead of print. PMID: 35816617.
