Berg, L.L. van den (Liseth) (2014) Surgery versus stereotactic ablative radiotherapy in patients with stage I and II non-small-cell lung cancer. thesis, Medicine.
![[img]](https://umcg.studenttheses.ub.rug.nl/style/images/fileicons/text.png) |
Text
BergvandenL.pdf Restricted to Registered users only Download (630kB) |
Abstract
Background Surgery is the standard treatment for patients with stage I and II non-small-cell lung cancer (NSCLC). However, 15% of these patients is medically inoperable due to poor performance status, frailty or severe comorbidity. For those, stereotactic ablative radiotherapy (SABR) is an alternative treatment. The aim of this study is to compare survival and tumor recurrences in patients with stage I or II NSCLC treated with surgery or SABR. Materials and methods In this retrospective study data from all stage I and II NSCLC patients treated between January 2007 and July 2010 with surgery or SABR were collected from the hospital database. SABR was given in 3-12 fractions with a total dose of 50-60 Gy. Primary endpoints were overall and disease-specific survival and overall tumor occurrences. Groups were compared using multivariable Cox regression analyses and competing risk analyses. Results A total of 374 patients with T1-2N0M0 NSCLC treated with surgery (n=157) or SABR (n=217) was included. Overall and disease-specific survival were significantly better in the surgical cohort (p<0.001 and p=0.002, respectively). In the surgical cohort patients were younger, less frail and had less comorbidities. After adjustment for these and other prognostic covariates, treatment did not influence the overall survival (adjusted HR SABR vs. surgery 1.24; 95% CI, 0.83-1.85; p= 0.297), but disease-specific survival was better with surgery (adjusted HR 2.27; 95% CI, 1.39-3.70; p=0.001). Significant more overall tumor occurrences (local tumor recurrences and distant metastases) were observed after SABR (p=0.026), but not after covariate adjustment (sHR 1.63; 95% CI, 0.98-2.72; p= 0.060). However, SABR was related to more local tumor recurrences compared with surgery (sHR 2.13; 95% CI, 1.01-4.51; p=0.048). Conclusions In patients with stage I and II NSCLC surgery provides a better local tumor control and disease-specific survival compared to SABR, although the overall survival and overall tumor occurrence is similar. SABR may be used as an alternative for patients unfit for surgery.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Groen, Prof. dr. H.J.M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:58 |
| Last Modified: | 25 Jun 2020 10:58 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1823 |
Actions (login required)
 |
View Item |