J Cancer 2020; 11(6):1634-1640. doi:10.7150/jca.39465

Research Paper

Choice of Treatment for Stage IA Non-small Cell Lung Cancer Patients Ineligible for Surgery: Ablation or Stereotactic Body Radiotherapy?

Long Liang1,2#, Guoshu Li1#, Shuanshuan Xie1#, Guifeng Sun2, Mengmei Zhang2, Fenyong Sun2, Aimei Peng1✉

1. Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
2. Department of Clinical Laboratory, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
# These authors have contributed equally to this work

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Citation:
Liang L, Li G, Xie S, Sun G, Zhang M, Sun F, Peng A. Choice of Treatment for Stage IA Non-small Cell Lung Cancer Patients Ineligible for Surgery: Ablation or Stereotactic Body Radiotherapy?. J Cancer 2020; 11(6):1634-1640. doi:10.7150/jca.39465. Available from https://www.jcancer.org/v11p1634.htm

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Abstract

Purpose: To compare the survival outcomes of ablation and stereotactic body radiotherapy (SBRT) in inoperable patients with stage IA non-small cell lung cancer (NSCLC).

Patients and Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 6,395 patients with stage IA NSCLC who had complete clinical information from 2004 to 2015. Kaplan-Meier analysis was performed to determine the propensity score based on the clinical characteristics of patients with stage IA NSCLC. Overall survival (OS) was compared between patients with stage IA NSCLC who were treated with ablation and SBRT after adjusting, stratifying, or matching.

Results: Kaplan-Meier analysis demonstrated no significant difference in survival curves (log-rank, p>0.05) between the ablation and SBRT groups. Compared with the SBRT group, the hazard ratio (HR) (95% confidence interval [CI]) of OS was 0.930 (0.817-1.058, p=0.269) in the ablation group on univariate analysis. On multivariate analysis, similar effects on OS (HR: 0.974, 95% CI: 0.858-1.105, p=0.680) were seen in patients with stage IA NSCLC in both the groups.

Conclusions: This study suggests that survival does not differ significantly between patients with stage IA NSCLC treated with ablation and SBRT. These results will be helpful for patients with stage IA NSCLC who are ineligible for surgery.

Keywords: Ablation, SBRT, non-small cell lung cancer, SEER, overall survival