Patient characteristics can help determine optimal treatment choices

This study explored the patient characteristics that predicted long-term survival following surgery or stereotactic body radiation therapy in non-small cell lung cancer.

While lung cancer is one of the most common cancers diagnosed, the disease is often not caught in the early stages. However, survival rates for non-small cell lung cancer have improved due to treatments such as stereotactic body radiotherapy, where radiation is targeted directly at the well-defined tumor. This is the best choice of treatment for patients who cannot undergo surgery. Surgical removal of the tumor, however, is still the optimal treatment option for patients with Stage I or II disease, which has not spread beyond the lung.

There are no set guidelines, though, for deciding who should receive surgery or radiation therapy, or which patient characteristics would be most helpful in making that decision. The current study examined the patient characteristics that predicted long-term survival following surgery or stereotactic body radiation therapy in Stage I and Stage II non-small cell lung cancer.

This retrospective study reviewed the records of 425 non-small cell lung cancer patients; 216 received surgery to remove their tumors and 209 underwent stereotactic body radiation therapy. Follow-up times ranged from 1–10 years.

Overall survival following surgery was 79% at 2 years, and 65% at 4 years. Overall survival following stereotactic body radiation therapy was 65% at 2 years, and 44% at 4 years. The presence of comorbidities, or other health issues, such as chronic obstructive pulmonary disease (COPD) reduced rates of overall survival in both treatment groups.

Local control (the cancer had not spread beyond the lung) rates were 88% at 2 years following surgery and 89% at 2 years following stereotactic body radiation therapy. At 4 years, rates were 85% following surgery and 83% following radiation therapy.

Characteristics associated with lower survival in the surgery patients included increased age, increased number of comorbidities, and Stage IIB lung cancer. Characteristics associated with lower survival following stereotactic body radiation therapy included a higher number of comorbidities, and Stages IA, IIA, and IIB lung cancer.

This study concluded that patient characteristics and survival differed between the surgical and stereotactic body radiation therapy patients. To optimize treatment, characteristics such as tumor stage and comorbidities should be taken into consideration.

Discuss with your physician the optimal treatment course for your situation.