Radiation vs. thermal – a comparison of strategies for the treatment of early lung cancer

This study compared stereotactic body radiation therapy (SBRT) and thermal ablative procedures (TAP) in early-stage non-small cell lung cancer (NSCLC). 

They found that overall survival (OS) was greater in SBRT-treated patients. 

Non-small cell lung cancer (NSCLC) is the most common form of lung cancer. Stereotactic body radiation therapy (SBRT) is the standard of care for inoperable NSCLC. It uses radiation waves to kill cancer cells and shrink the tumor. There are other treatments that do not involve using radiation. These are called thermal ablative procedures (TAPs). TAPs use electrical waves to shrink tumors. The heat generated by the waves causes cancer cells to die. Radiofrequency ablation (RFA) is a TAP. 

There is more clinical experience with SBRT compared to TAPs. Some studies suggest that TAPs may be useful in the treatment of NSCLC over SBRT. It is unclear if the safety and/or effectiveness of TAP is similar or better than SBRT. 

This study included 27,734 patients with early NSCLC. 4% of patients underwent TAP. 96% underwent SBRT. Patient records were obtained and analyzed. The average follow-up time was 26.7 months. The authors compared overall survival (OS) between the groups. 

43.9% of patients were alive at follow-up. OS was significantly better in SBRT patients compared to TAP. The average OS for SBRT patients was 37.7 months. The average OS for TAP patients was 33.5 months. OS rates were higher at 1, 2 and 5 years in the SBRT group compared to the TAP group (89% vs 82.9% at 1 year, 69.7% vs 62.7% at 2 years, and 34.4% vs 26.4% at 5 years). 

The authors concluded that OS was greater in SBRT-treated patients.

This was a retrospective study meaning it looked back at medical records. Some patient information was not available. The number of patients treated with SBRT was much higher than TAP. This could impact the findings. More investigation is needed. 

If you have any concerns regarding lung cancer treatment, please consult with your physician.