| Qian Kun,Dong Baiqiang,Lu Fangxiao,Chen Ming,Cao Jianping.Comparison of the treatment outcomes between video-assisted thoracoscopic lobectomy and stereotactic body radiotherapy for early-stage non-small cell lung cancer[J].Chinese Journal of Radiological Medicine and Protection,2020,40(6):439-445 |
| Comparison of the treatment outcomes between video-assisted thoracoscopic lobectomy and stereotactic body radiotherapy for early-stage non-small cell lung cancer |
| Received:October 24, 2019 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.06.005 |
| KeyWords:Non-small cell lung cancer Video-assisted thoracoscopic surgery Stereotactic body radiotherapy Propensity score matching Treatment outcome |
| FundProject:国家自然科学基金（81872552，81673100，U1967220） |
| Author Name | Affiliation | E-mail | | Qian Kun | School of Radiation Medicine and Protection, Medical College of Soochow University, State Key Laboratory of Radiation Medicine and Protection, Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Jiangsu Provincial Key Laboratory of Radiation Medicine and Protection, Suzhou 215123, China | | | Dong Baiqiang | Department of Radiation Oncology, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Hangzhou 310022, China | | | Lu Fangxiao | Department of Radiology, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou 310022, China | | | Chen Ming | Department of Radiation Oncology, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Hangzhou 310022, China | | | Cao Jianping | School of Radiation Medicine and Protection, Medical College of Soochow University, State Key Laboratory of Radiation Medicine and Protection, Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Jiangsu Provincial Key Laboratory of Radiation Medicine and Protection, Suzhou 215123, China | jpcao@suda.edu.cn |
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| Abstract:: |
| Objective To make comparisons of treatment outcomes between video-assisted thoracoscopic surgery (VATS) lobectomy and stereotactic body radiotherapy (SBRT) for early stage non-small cell lung cancer (NSCLC). Methods Overall survival (OS), cancer specific survival (CSS), locoregional control (LRC), and disease-free survival (DFS) were retrospectively compared between early stage NSCLC patients who underwent VATS lobectomy and SBRT at our institution from January 2012 to December 2016. Propensity score matching (PSM) was carried out to reduce selection bias between two groups based on age, gender, Karnofsky performance score (KPS), Charlson comorbidity index (CCI), pulmonary function, and tumor diameter. Results A total of 567 patients treated with VATS lobectomy (n=458) or SBRT (n=109) were included. 104 patients were matched for further analysis (52 in VATS lobectomy group and 52 in SBRT group). The median follow-up time was 44 months. the 3- and 5-year OS were 94.2% and 91.6% for VATS lobectomy and 88.6% and 79.9% for SBRT (P=0.097), respectively. No statistically significant differences were noted in 5-year CSS (91.6% vs. 83.7%, P=0.270). The cumulative incidence of LRC was comparable between two group (94.0% and 85.9% vs. 93.5% and 93.5% at 3, 5 years, P=0.621). Differences in the DFS were not statistically significant (80.5% and 79.0% at 5 years, P=0.624). In the VATS lobectomy group, 10% patients (n=5) experienced ≥ grade 3 CTCAE toxicity. One patient died of septicemia due to severe lung infection within 30 d after VATS lobectomy. In the SBRT group, one patient suffered from grade 3 radiation pneumonitis. There were no grade 4 or 5 toxicities in SBRT group. Conclusions This propensity matched analysis suggests that SBRT can be an alternative option to VATS lobectomy for stage I-II NSCLC. Randomized trials are needed to evaluate the outcomes. |
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