SABR Improves Overall Survival Compared With CRT in NSCLC

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The purpose of this study was to compare the effectiveness of SABR with CRT in prolonging time to local failure in this patient population.
The purpose of this study was to compare the effectiveness of SABR with CRT in prolonging time to local failure in this patient population.
The following article features coverage from the IASLC 18th World Conference on Lung Cancer (WCLC) in Yokohama, Japan. Click here to read more of Cancer Therapy Advisor's conference coverage.

Stereotactic ablative body radiotherapy (SABR) was associated with improved overall survival (OS) and superior freedom from local failure compared with conventional fully fractionated radiotherapy (CRT) among patients with inoperable stage I non–small cell lung cancer (NSCLC), according to results presented at the International Association for the Study of Lung Cancer (IASLC) 18th Annual World Conference on Lung Cancer (WCLC) in Japan.1

SABR has been established as a treatment method for patients with stage I NSCLC, but there is a lack of evidence regarding its superiority to CRT. The purpose of this study was to compare the effectiveness of SABR with CRT in prolonging time to local failure in this patient population.

For this randomized phase 3 study, researchers assigned 101 patients who refused surgery or had inoperable stage I NSCLC to receive SABR (54 Gy in 3 fractions or 48 Gy in 4 fractions) or CRT (66 Gy in 33 fractions or 50 Gy in 20 fractions). Sixty-six patients received SABR and 35 patients received CRT.

Eligible patients must have had good ECOG performance scores (0 or 1); the distance between the tumor and the lobar bronchus bifurcation must have been 2 cm or greater.

Living patients were followed for at least 2 years.

Patients in the SABR arm had superior freedom from local failure compared with patients in the CRT arm (hazard ratio [HR], 0.29; 95% CI, 0.130-0.662; P = .002), as well as improved overall survival (HR, 0.51; 95% CI, 0.51-0.911; P = .02).

Grade 3 toxicities were reported in 2 and 9 patients in the CRT and SABR arms, respectively, and a grade 4 toxicity was observed in 1 patient in the SABR arm.

Read more of Cancer Therapy Advisor's coverage of the IASLC 18th World Conference on Lung Cancer (WCLC) by visiting the conference page.

Reference

  1. Ball DL, Mai T, Vinod SK, et al. A randomized trial of SABR vs conventional radiotherapy for inoperable stage I non-small cell lung cancer: TROG 09.02 (CHISEL). Presented at: International Association for the Study of Lung Cancer 18th World Conference on Lung Cancer; Yokohama, Japan: October 15-18, 2017. Abstract OA 01.01.

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