Stereotactic ablative radiotherapy (SABR) could be an option for treating patients with operable stage I non-small cell lung cancer (NSCLC), a recent study published online first in the journal The Lancet Oncology has shown.
For the study, researchers conducted a pooled analysis of the STARS and ROSEL studies, which closed early due to slow accrual. In the intention-to-treat population, 58 patients with clinical T1-2a, N0M0, operable NSCLC were enrolled and randomly assigned 1:1 to SABR or lobectomy with mediastinal lymph node dissection or sampling.
Results showed that estimated overall survival at 3 years was 95% (95% CI: 85-100) in the SABR group versus 79% (95% CI: 64-97) in the lobectomy group (HR = 0.14; 95% CI: 0.017-1.190; log-rank P = 0.037). Researchers found that recurrence-free survival at 3 years was 86% (95% CI: 74-100) and 80% (95% CI: 65-97) in the SABR and surgery groups, respectively (HR = 0.69; 95% CI: 0.21-2.29; log-rank P = 0.54).
The researchers note that because of the small patient sample size and median follow-up of only 40.2 months in the SABR group and 35.4 months in the surgery group, additional randomized studies comparing the two in patients with operable NSCLC are needed.
SABR for inoperable stage I NSCLC has shown promising results, but two independent, randomised, phase 3 trials of SABR in patients with operable stage I NSCLC closed early due to slow accrual. We aimed to assess overall survival for SABR versus surgery by pooling data from these trials.