SABR Noninferior to Surgery for Early NSCLC Patients
Summary of the Study on SABR vs. Surgery for Stage I NSCLC
This study, presenting 10-year follow-up data from the STARS trial, compared stereotactic ablative radiotherapy (SABR) to surgery (lobectomy) for patients with operable Stage I Non-Small Cell Lung Cancer (NSCLC). Here’s a breakdown of the key findings:
Study Design & Participants:
* Participants: 160 patients (80 in each group)
* Follow-up: Median of 8.3 years
* Staging: Endobronchial ultrasound was used for staging in all SABR patients, but only 25% of surgery patients (meaningful difference, p < .001).
* Baseline Characteristics: Generally similar between groups, with no other significant differences.
Key Results:
* Overall Survival (OS): No significant difference between SABR and surgery (HR 0.77, p = .417). SABR demonstrated non-inferiority to surgery. Median OS was not reached for the SABR group, while it was 11.4 years for the surgery group.
* lung Cancer-Specific Survival: No significant difference (HR 0.95, p = .928).
* Recurrence-Free Survival: No significant difference (HR 1.17, p = .586).
* OS Rates: Similar at 7 and 10 years:
* SABR: 81% (7-year), 69% (10-year)
* Surgery: 70% (7-year), 66% (10-year)
* Occult Lymph Node Involvement: Found in 11% of surgery patients, leading to adjuvant therapy in 14%.
* Quality of Life/Financial Toxicity (SABR group only): Of the 60 patients surveyed, 28% responded. Among responders, 53% reported no financial burden from radiation-related costs.
Conclusion:
The study supports SABR as a strong option to surgery for most patients with operable Stage I NSCLC, offering comparable long-term survival with possibly easier recovery and better quality of life.