Stereotactic ablative radiotherapy for treating NSCLC

This study aimed to assess the effectiveness of stereotactic ablative radiotherapy (SABR) treatment in patients with second primary lung cancer and whether CT surveillance would be beneficial to these patients. The review concluded that SABR is an effective treatment in patients with early stage NSCLC who are unable to undergo surgery. They also concluded that there was no difference in effectiveness of SABR between patients with first primary lung cancer and SPLC.

Patients with early stage non-small-cell lung cancer (NSCLC) who have had curative treatment can develop second primary lung cancer. It is suggested that these patients undergo routine surveillance with CT scans to find second lung cancers. However, some of these patients may not be fit for further surgery and therefore need other treatment options.

SABR involves high dose radiation focused on a tumor with limited radiation to other organs. SABR may therefore be effective in NSCLC patients unable to undergo surgery. 

This reviewed aimed to determine whether SABR was effective in treating patients with a second lung cancer not able to undergo surgery.

Information on 863 patients who had undergone SABR for stage I NSCLC was reviewed. 107 of these patients had a second primary lung cancer. 756 patients were treated for a first primary lung cancer.

In secondary lung cancer patients treated with SABR, average 3 year overall survival (time from treatment until death from any cause) was 60% and 3 year local control (stopped cancer growth at the site of origin) was 89%. These were not significantly different from patients treated for a first lung cancer.

11% of patients developed further primary lung cancers an average of 20 months after SABR. There were only 4 cases of severe side effects following SABR.

The study concluded that SABR was safe and effective in patients who developed a second primary lung cancer who were not able to undergo surgery. Because of this, the authors recommended that CT surveillance should be routine in this population of patients.