Can stereotactic body radiotherapy can be used as an alternative to minimal invasive surgery for early-stage non-small cell lung cancer?

This article compared the use of video-assisted thoracoscopic lobectomy (VATL) versus stereotactic body radiotherapy (SBRT) for the treatment of early-stage non-small cell lung cancer (NSCLC). The authors found that SBRT could provide an alternative treatment option for these patients. 

Early-stage NSCLC is increasingly being diagnosed due to the use of low-radiation imagining. VATL is a minimally invasive surgery that involves the surgical removal of a portion of the lung called a lobe through small cuts in the chest. It is the best curative option for patients with early-stage NSCLC. However, This surgery comes with many risks and some patients cannot undergo VATL. 

Other treatment options such as SBRT are available for patients with early-stage NSCLC. SBRT uses high-dose radiation delivered precisely at the tumor. This allows the preservation of surrounding tissue. Current guidelines recommend using SBRT in patients who cannot undergo surgery. However, there is no comparison between the outcomes of patients with early-stage NSCLC treated with SBRT vs VATL. 

There were a total of 567 patients with early-stage NSCLC included in this study. 109 patients received SBRT and 458 patients were treated with VATL. The average length of follow-up was 44 months. 

At 3 years follow-up, 88.6% of the SBRT group and 94.2% of the VATL group were alive. At 5 years, 79.9% of the SBRT group and 91.6% of the VATL group were alive. The local recurrence rates were similar between both groups at 5 years. Survival without the disease at 5 years was also similar between groups (80.5% for SBRT and 84.3% for VATL).

15% of the patients in the SABR group had side effects such as shortness of breath. 56% of the VATL group had complications after surgery. 

The authors concluded that SBRT can be used as an alternative treatment option to VATL for patients with early-stage NSCLC.

This study was based on medical records data. Therefore, patients were assigned to each treatment group based on their preference or their overall health status. This might have influenced the results.