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Adverse Events Following Limited Resection versus Stereotactic Body Radiation Therapy for Early Stage Lung Cancer.
- Source :
-
Annals of the American Thoracic Society [Ann Am Thorac Soc] 2022 Dec; Vol. 19 (12), pp. 2053-2061. - Publication Year :
- 2022
-
Abstract
- Rationale: Approximately a quarter of patients with early stage lung cancer are not medically fit for lobectomy. Limited resection and stereotactic body radiation therapy (SBRT) have emerged as alternatives for these patients. 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. Objectives: To compare the AE profile between SBRT versus limited resection. Methods: Data were derived from a prospective cohort of patients with stage I-IIA non-small cell lung cancer who were deemed as high-risk for lobectomy recruited from five centers across the United States. Propensity scores and inverse probability weighting were used to compare the rates of 30- and 90-day AEs among patients treated with limited resection versus SBRT. Results: Overall, 65% of 252 patients underwent SBRT. After adjusting for propensity scores, there was 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). SBRT was associated with lower risk of infectious AEs than limited resection at 30 days (OR: 0.05; 95% CI: 0.01-0.39) and 90 days posttreatment (OR: 0.41; 95% CI: 0.17-0.98). Additionally, SBRT was associated with 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). Conclusions: Though equivalent in developing at least one AE, we found 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 posttreatment. This information, combined with data about oncologic effectiveness, can help patients' decision-making regarding these alternative therapies.
- Subjects :
- Humans
United States
Prospective Studies
Neoplasm Staging
Treatment Outcome
Fatigue
Radiosurgery adverse effects
Carcinoma, Non-Small-Cell Lung radiotherapy
Carcinoma, Non-Small-Cell Lung surgery
Carcinoma, Non-Small-Cell Lung pathology
Lung Neoplasms radiotherapy
Lung Neoplasms surgery
Lung Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 2325-6621
- Volume :
- 19
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Annals of the American Thoracic Society
- Publication Type :
- Academic Journal
- Accession number :
- 35816617
- Full Text :
- https://doi.org/10.1513/AnnalsATS.202203-275OC