The adoption of stereotactic body radiation therapy (SBRT) is associated with substantial improvements in overall and lung cancer-specific survival rates among US veterans with stage I non-small cell lung cancer (NSCLC), according to a study presented at the 58th American Society for Radiation Oncology (ASTRO) annual meeting.1

Radiotherapy for stage I NSCLC is recommended only for patients unable to tolerate surgery or for those who prefer non-surgical management of their disease. Although SBRT was developed in the 1990s to deliver highly-targeted radiation and limit damage to surrounding tissue, its use has increased in recent years. Researchers evaluated the impact of SBRT use in outcomes of patients with stage I NSCLC treated between 2001 and 2010.

Investigators analyzed data from more than 14,000 patients included in the Veteran’s Affairs Central Cancer Registry (VACCR), including 3012 patients who received radiotherapy as their primary treatment. Of those, 468 had SBRT and 1203 received conventional radiotherapy.

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At 4 years of follow-up, 4-year overall survival was 37.0% with SBRT, in contrast with 18.8% with conventional radiotherapy. Four-year lung cancer-specific survival was 53.2% and 28.3% for patients treated with SBRT and conventional radiotherapy, respectively.

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After adjustment for confounding factors, it was found treatment with SBRT was associated with a 28% risk of death reduction, in contrast with conventional radiotherapy. Older age, higher Charlson comorbidity score, and extent of disease also correlated with improved survival. Use of PET scans for staging or treatment era did not affect survival.                     


  1. Advances in radiation therapy have improved survival rates for early stage lung cancer patients. American Society for Radiation Oncology (ASTRO) website. Updated September 25, 2016. Accessed September 27, 2016.