Comparison of outcome between stereotactic body radiotherapy (SBRT) and surgery in cN0 non-small cell carcinoma of the lung

Abstract

Objective. The aim of the study is to compare the outcome of stereotactic body radiotherapy (SBRT) with that of surgery for non-small cell lung cancer (NSCLC). Methods. Patients with cN0 NSCLC who were treated by SBRT (SBRT group) or surgery (OP group) from January 2003 to December 2010 were included in this study. Results. The SBRT group consisted of 30 patients: 14 adenocarcinomas, 11 squamous cell carcinomas and 5 others. The radiation dose given at the isocenter was 50 Gy/5 fr in 12, 60 Gy/8 fr in 3,48 Gy/4 fr in 9 and 50 Gy/4 fr in 6. The OP group consisted of 575 patients: 417 adenocarcinomas, 124 squamous cell carcinomas and 34 others. Surgical method was pneumonectomy in 3, lobectomy in 507, segmentectomy in 38 and wedge resection in 27. The SBRT group had a higher age, worse performance status (PS) and lower %FEV 1.0 than the OP group. The 5-year survival rate was 51.0% for the SBRT group and 77.4% for the OP group with a significant difference (p = 0.012), but there was no significant difference regarding disease-specific survival. There was no significant difference in survival between the two groups in multivariate analysis and case-matching analysis using propensity scores. Conclusion. The equivalent outcome could be expected in SBRT and surgery for the treatment of the patients with cN0 NSCLC. © 2012 The Japan Lung Cancer Society.