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Stereotactic body radiotherapy improved initial survival rates for those with COPD

Posted on Mar 19, 2012

Stereotactic body radiotherapy offered better 30-day mortality rates than surgery for patients with lung cancer who had severe chronic obstructive pulmonary disease, according to study results published in the International Journal of Radiation, Oncology, Biology, Physics.

To compare the outcome of patients with non–small cell lung cancer who had severe chronic obstructive pulmonary disease (COPD) and underwent stereotactic body radiotherapy vs. surgical intervention, researchers evaluated a single-institution cohort of 176 patients with stage III or IV COPD and stage I NSCLC.

In addition, the systematic review identified four other studies — two surgical (n=121) and two stereotactic body radiotherapy (n=75) — in which stereotactic body radiotherapy studies were found to be more recent and included older patients than surgical studies.

According to study results, the median follow-up was 21 months and median OS was 32 months — the severity of patient COPD was observed to be associated with OS (P=.01). In particular, the mean 30-day mortality rate for patients who received stereotactic body radiotherapy was 0% vs. 10% for patients who underwent surgery.

“[Stereotactic body radiotherapy] is associated with low risks of operative mortality, rarely requires a hospital stay, and is associated with a favorable toxicity profile,” the researchers said. “However, this review indicates that published data reporting survival outcomes in patients with severe COPD and stage I NSCLC are lacking.”

Study results indicated that stereotactic body radiotherapy achieved comparable long-term survival outcomes to surgical resection — 1-year OS for patients who received stereotactic body radiotherapy was 79% to 95%, whereas 1-year OS for surgical patients was 45% to 86%.

“[Stereotactic body radiotherapy] is a safe and effective less-invasive option for lung cancer patients with COPD that does not have the added risks of surgery-related mortality and prolonged hospitalization,” study researcher David Palma, MD, MSc, a radiation oncologist at the London Regional Cancer Program in London, Ontario, Canada, said in a press release. “All eligible patients should be evaluated in a multidisciplinary setting and afforded an informed decision of the risks and benefits of both surgery and [stereotactic body radiotherapy].”

Palma D. Int J Radiat Oncol Biol Phys.2012;82:1149-1156.

Disclosure: The researchers report that the VU University Medical Center has a research collaboration with Varian Medical Systems.


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