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N.C.G. Hansen

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    P1.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 209)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Localized Disease - NSCLC
    • Presentations: 1
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      P1.02-038 - A Comparison of Stereotactic Body Radiation Therapy vs. No Treatment for Patients with Early-Stage Non-Small Cell Lung Cancer (ID 1449)

      09:30 - 17:00  |  Author(s): N.C.G. Hansen

      • Abstract
      • Slides

      Scarce information is available concerning the natural history of untreated patients with early-stage Non-Small Cell Lung Cancer (NSCLC). No randomized studies have been conducted comparing Stereotactic Body Radiation Therapy (SBRT) with no treatment for patients with early-stage NSCLC. Previously, it has been suggested that SBRT increases overall survival for patients with NSCLC T1-2N0M0. In this study a national group of untreated patients with early-stage NSCLC was identified in order to compare the effect of SBRT with the natural history in a retrospective setting.

      From 2007 to 2013, 136 patients diagnosed NSCLC T1-2N0M0 with a tumor diameter up to 5 cm were treated with SBRT at Odense University Hospital. The thoracic RT consisted of 45-66 Gy/3 F delivered in 9 days. For the same period, a national group of 121 untreated patients with early-stage NSCLC was extracted from the Danish Lung Cancer Registry. Of these, 85 patients survived more than one month after the diagnosis was established and might have been candiates to SBRT. Twenty-four patients with unrecorded tumor diameter were excluded from the present analysis thus, 61 patients remained in the untreated group. Pathoanatomical diagnosis was known for all patients. Kaplan-Meier and Cox proportional hazard analyses were used for uni- and multivariable survival analyses, respectively. Overall survival (OS) was calculated from the date of diagnosis.

      The mean age was 72 vs. 78 years in the SBRT and untreated group, respectively. Statistically significant (p<0.05) inter-group differences in patient characteristics were observed for pathological type and FEV1 (%predicted). No difference in gender, tumor size, ECOG performance status, or pack years was observed. The potential median follow-up time was 38 months in the SBRT group vs. 57 months among untreated. A log rank test showed a significant difference of overall survival (OS) between groups e.g. resulting in an OS at 5-year of 44% vs. 10% respectively and a median OS of 47.8 vs. 12.2 months for SBRT and untreated group, respectively (p < 0.01). Multivariate analysis indicated that age, tumor size, pack years, gender, adenocarcinoma and FEV1 (%predicted) had no significant influence on survival, while SBRT and ECOG performance status had (Table 1). Figure 1

      In this study SBRT was associated with significantly longer OS compared to no treatment, suggesting that SBRT is a convenient treatment that increases survival for patients with early-stage NSCLC.

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