Treatment Outcomes in Stage I Lung Cancer: A Comparison of Surgery and Stereotactic Body Radiation Therapy

Poullis, Michael

doi:10.1016/j.jtho.2016.02.012

Cited by 6 publications

(4 citation statements)

References 6 publications

(5 reference statements)

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“…However, there were only 26 cases in this population, and there was a large offset. Similar to previous ndings, surgery yielded better outcomes in other age groups [24]. In the age group > = 81 years, the patients who opted for radiotherapy were about four times more likely to choose the surgery group, and the same was true for the results of the early study [25,26].…”

Section: Discussionsupporting

confidence: 71%

Survival Benefit of Surgery Versus Radiotherapy Alone to Patients with Stage IA Lung Adenocarcinoma: A Propensity Score-Matched Analysis

Zhan¹,

Zeng²,

Li³

et al. 2023

Preprint

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Section: Discussionsupporting

confidence: 71%

Survival Benefit of Surgery Versus Radiotherapy Alone to Patients with Stage IA Lung Adenocarcinoma: A Propensity Score-Matched Analysis

Zhan¹,

Zeng²,

Li³

et al. 2023

Preprint

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“…Dr. Poullis, in his letter to the editor, and several others in personal communications to the authors have highlighted some of the main limitations with which any retrospective analysis is burdened. 2 At the outset, we must state that we agree with many of the criticisms leveled. Nevertheless, in the face of multiple failed prospective trials, we used the largest available retrospective data set to understand the application and outcomes of the two treatment strategies.…”

Section: In Response To Treatment Outcomes In Stage I Lung Cancer: a mentioning

confidence: 90%

In Response to Treatment Outcomes in Stage I Lung Cancer: A Comparison of Surgery and Stereotactic Body Radiation Therapy

Robinson

2016

Journal of Thoracic Oncology

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“…Although the guidelines for the treatment of NSCLC only recommend SBRT in inoperable patients [7][8][9], a pooled analysis of clinical trials suggested equipoise for overall survival between SBRT and surgery in operable patients [10]. Observational studies, however, showed a better overall survival after surgery [16,[31][32][33][34], although these studies may be subject to unmeasured and consequently unadjusted selection bias, as a result of patient selection or physician preferences for surgery or SBRT [35,36].…”

Section: Stage I and Iimentioning

confidence: 99%

Trends and variations in treatment of stage I–III non-small cell lung cancer from 2008 to 2018: A nationwide population-based study from the Netherlands

et al. 2021

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This Dutch population-based study describes nationwide treatment patterns and its variations for stage I-III non-small cell lung cancer (NSCLC). Materials and methods: Patients diagnosed with clinical stage I-III NSCLC in the period 2008-2018 were selected from the Netherlands Cancer Registry. Treatment trends were studied over time and age groups. Use of radiotherapy versus surgery (stage I-II), and concurrent versus sequential chemoradiotherapy (stage III) were analyzed by logistic regression. Results: In stage I, the rate of surgery decreased from 58 % (2008) to 40 % (2018) while radiotherapy use increased over time (from 31 % to 52 %), which mostly concerned stereotactic body radiotherapy (74 %). In stage II, 54 % of patients received surgery, and use of radiotherapy alone increased from 18 % to 25 %. The strongest factors favoring radiotherapy over surgery were WHO performance status (OR ≥ 2 vs 0: 23.39 (95% CI: 18.93− 28.90)), increasing age (OR ≥ 80 vs <60 years: 14.52 (95% CI: 13.02− 16.18)) and stage (OR stage II vs I: 0.61 (95% CI: 0.57− 0.65)). In stage III, the combined use of chemotherapy and radiotherapy increased from 35 % (2008) to 39 % ( 2018). In all years, 23 % received concurrent chemoradiotherapy, 9 % sequential chemoradiotherapy, 23 % radiotherapy or chemotherapy alone, and 25 % best supportive care. The strongest factors favoring concurrent over sequential chemoradiotherapy were age (OR ≥ 80 vs <60 years: 0.14 (95% CI: 0.10− 0.19)), WHO Performance status (OR ≥ 2 vs 0: 0.33 (95% CI: 0.24− 0.47)) and region (OR east vs north: 0.39 (95% CI: 0.30− 0.50)). Conclusions: The use of radiotherapy became more prominent over time in stage I NSCLC. Combined use of chemotherapy and radiotherapy marginally increased in stage III: only one third of patients received chemoradiotherapy, mainly concurrently. Treatment variation seen between patient groups suggests tailored treatment decision, while variation between hospitals and regions indicate differences in clinical practice.

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Treatment Outcomes in Stage I Lung Cancer: A Comparison of Surgery and Stereotactic Body Radiation Therapy

Cited by 6 publications

References 6 publications

Survival Benefit of Surgery Versus Radiotherapy Alone to Patients with Stage IA Lung Adenocarcinoma: A Propensity Score-Matched Analysis

Survival Benefit of Surgery Versus Radiotherapy Alone to Patients with Stage IA Lung Adenocarcinoma: A Propensity Score-Matched Analysis

In Response to Treatment Outcomes in Stage I Lung Cancer: A Comparison of Surgery and Stereotactic Body Radiation Therapy

Trends and variations in treatment of stage I–III non-small cell lung cancer from 2008 to 2018: A nationwide population-based study from the Netherlands

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