Changes in quality of life after surgery or radiotherapy in early-stage lung cancer

BACKGROUND: Although surgical resection is considered the standard of care for early-stage non-small cell lung cancer, radiotherapy [stereotactic body radiation therapy (SBRT)] has been proposed as a minimally invasive treatment alternative. Studies have not examined differences in quality of life (QoL) between surgery and radiotherapy, despite important implications for patient and provider decision making. METHODS: The Surveillance, Epidemiology, and End Results Medicare Health Outcomes Survey (1998–2014) was used to assess changes in physical QoL score [Physical Component Summary (PCS)] and mental health QoL score [Mental Component Summary (MCS)] from baseline (prior to cancer diagnosis) to follow-up after treatment with surgery only or radiotherapy only. QoL was measured using the 36-item Short Form Health Survey (SF-36) until 2006, when it was replaced by the Veterans RAND 12-Item Health Survey (VR-12). RESULTS: Data from 184 patients (28 SBRT, 156 surgery) was included. There was a significant decline in PCS score from baseline to follow-up (surgery: −4.81; 95% CI: −6.31, −3.30; P