SABR for Early Non-Small Cell Lung Cancer: Changes in Pulmonary Function, Dyspnea, and Quality of Life

Abstract

The aim of this study is to report pulmonary function tests (PFTs), clinician-reported and patient-reported QoL outcomes on a cohort of NSCLC patients treated with SABR. 119 patients with NSCLC were treated with SABR in the prospective cohort SSBROC study of patients with T1-T2N0M0 NSCLC. PFTs and quality of life measures were obtained at baseline pre-treatment and 6 monthly. Here we report on the 6- to 18-month time points. ANCOVA methods adjusting for baseline analysed potential predictors on outcomes of PFT and patient-reported dyspnoea at 18 months. The only statistically significant decline in PFTs was seen in FEV1 at 18 months post-SABR with a decline of -0.11L (p = 0.0087, 95% CI -0.18 to -0.02). Of potential predictors of decline, only a 1 unit increase in smoking pack years resulted in a -0.12 change in DLCO (p = 0.026, 95% CI -0.02 to -0.23) and a 0.003 decrease in FEV1 (p = 0.026, 95% CI -0.006 to -0.0004). For patient reported outcomes, statistically significant worsening in both QLQC30 and QLQLC13 dyspnoea scores occurred at the 18-month time point, but not earlier. No potential predictors of worsening dyspnoea were statistically significant. There was no statistically significant decline in clinician-reported outcomes or global QoL scores. We found a statistically significant decline in FEV1 at 18 months post-treatment. Smoking pack years was a predictor for decline in DLCO and FEV1 at 18 months. Worsening of patient-reported dyspnoea scores was observed, consistent with the expected progression of lung co-morbid disease.