Comparative analysis of clinical efficacy between stereotactic ablative radiotherapy and surgery for early-stage non-small cell lung cancer

Abstract

Objective To compare the clinical efficacy and safety between stereotactic ablative radiotherapy (SABR) and surgery in the treatment of early-stage non-small cell lung cancer (NSCLC). Methods A total of 227 patients who were initially diagnosed with early-stage NSCLC and with complete clinical data admitted to Henan Cancer Hospital between June 2012 and December 2016 were recruited and assigned into the SABR (n=73) and surgery groups (n=154). Kaplan-Meier method was used to calculate survival rate and survival comparison was performed using the log-rank test. Chi-square test was adopted to compare the baseline data between two groups. Results All patients completed corresponding treatment. The samples of SABR group and operation group were 74 and 155 cases respectively. The 1-year and 3-year overall survival (OS) rates in the SABR and surgery groups were 97.2%, 81.9% and 96.5%, 78.2%(P=0.603), respectively. The 1-year and 3-year progression-free survival (PFS) rates in the SABR and surgery groups were 90.1%, 66.9% and 89.2%, 66.9%(P=0.565), respectively. The 1-year and 3-year locoregional recurrence-free survival rates in the SABR and surgery groups were 92.8%, 84.0% and 96.5%, 90.8%(P=0.133), respectively. The 1-year and 3-year distant metastasis-free survival rates in the SABR and surgery groups were 97.2%, 75.4% and 89.2%, 69.8%(P=0.095), respectively. Conclusions SABR and surgery yield similar OS, PFS, locoregional recurrence-free and distant metastasis-free survival rates in the treatment of early-stage NSCLC. Therefore, SABR is an alternative treatment for patients with early-stage NSCLC. Key words: Carcinoma, non-small cell lung/radiotherapy; Radiotherapy, stereotactic ablative; Prognosis