SBRT of lung cancerStereotactic body radiotherapy and treatment at a high volume facility is associated with improved survival in patients with inoperable stage I non-small cell lung cancer
Section snippets
Database
The National Cancer Database (NCDB) is a hospital-based cancer registry that collects data from the American College of Surgeons (ACoS)-Commission on Cancer (CoC) accredited facilities [17]. The requirements for CoC accreditation include the cancer program meeting 34 CoC quality care standards, the facility undergoing an onsite survey every 3 years, and maintaining levels of excellence in the delivery of patient centered care. ACoS and the American Cancer Society sponsor the database. The
Results
From 2003 to 2006, there were 13,036 patients who met eligibility criteria for the study. The study included 1196 different treatment facilities, of which 153 performed SBRT. Of the cohort, 52% (n = 6888) received no therapy, 41% (n = 5375) received conventional radiation therapy and 6% (n = 773) received stereotactic body radiotherapy. Patient characteristics are shown in Table 1.
The median follow up was 21 months (interquartile range 11–43 months) in all patients and 68 months (interquartile range
Discussion
This study reveals meaningful survival gains with the use of SBRT over both conventional radiotherapy as well as observation, results that suggest a broad societal benefit to this modern radiotherapy technology. This analysis therefore provides significant support to the hypothesis that curative radiotherapy – and in particular, SBRT – improves overall survival in this vulnerable population, and it is one of the first studies to show population-level effectiveness gains from stereotactic
Funding
None.
Conflict of interest statement
The authors state that they have no relationships, conditions or circumstances that present potential conflicts of interest with this study.
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2020, Radiotherapy and OncologyDifferential Relapse Patterns for Non-small Cell Lung Cancer Subtypes Adenocarcinoma and Squamous Cell Carcinoma: Implications for Radiation Oncology
2019, Clinical OncologyCitation Excerpt :Two studies comparing hyperfractionated accelerated radiotherapy showed less improvement in local control in patients with non-squamous compared with SCC [24,25]. A study of 13 306 patients treated in the USA [26] found that patients with SCC treated with SABR derived more benefit in survival compared with patients with adenocarcinoma and concluded that this may be due to a difference in metastatic potential between the two histological subtypes. More aggressive local therapy may be more effective in SCC, given its propensity to relapse locally.