Stage I-II non-small-cell lung cancer treated usingeither stereotactic ablative radiotherapy (SABR) orlobectomy by video-assisted thoracoscopic surgery(VATS): Outcomes of a propensity score-matchedanalysis

N. E. Verstegen, J. W.A. Oosterhuis, D. A. Palma, G. Rodrigues, F. J. Lagerwaard, A. van der Elst, R. Mollema, W. F. van Tets, A. Warner, J. J.A. Joosten, M. I. Amir, C. J.A. Haasbeek, E. F. Smit, B. J. Slotman, S. Senan

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Background: Video-assisted thoracoscopic surgery (VATS) lobectomy and stereotactic ablative radiotherapy (SABR)are both used for early-stage non-small-cell lung cancer. We carried out a propensity score-matched analysis tocompare locoregional control (LRC).Patients and methods: VATS lobectomy data from six hospitals were retrospectively accessed; SABR data wereobtained from a single institution database. Patients were matched using propensity scores based on cTNM stage,age, gender, Charlson comorbidity score, lung function and performance score. Eighty-six VATS and 527 SABRpatients were matched blinded to outcome (1:1 ratio, caliper distance 0.025). Locoregional failure was defined asrecurrence in/adjacent to the planning target volume/surgical margins, ipsilateral hilum or mediastinum. Recurrenceswere either biopsy-confirmed or had to be PET-positive and reviewed by a tumor board.Results: The matched cohort consisted of 64 SABR and 64 VATS patients with the median follow-up of 30 and 16months, respectively. Post-SABR LRC rates were superior at 1 and 3 years (96.8% and 93.3% versus 86.9% and82.6%, respectively, P = 0.04). Distant recurrences and overall survival (OS) were not significantly different.Conclusion: This retrospective analysis found a superior LRC after SABR compared with VATS lobectomy, but OSdid not differ. Our findings support the need to compare both treatments in a randomized, controlled trial.

Originele taal-2Engels
Pagina's (van-tot)1543-1548
Aantal pagina's6
TijdschriftAnnals of Oncology
Volume24
Nummer van het tijdschrift6
DOI's
StatusGepubliceerd - jun. 2013
Extern gepubliceerdJa

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