<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_raon-2017-0058_s_006">
<h3>Background</h3>
<p>Stereotactic ablative radiotherapy (SABR) is a promising option for non-operated early-stage non-small cell lung cancer (NSCLC) compared to conventional fractionated radiotherapy (CFRT). However, results from conclusive randomized controlled trials are not yet available. The aim of our study was to explore the effectiveness of SABR vs. CFRT for non-operated early-stage NSCLC.</p></sec>
<sec id="j_raon-2017-0058_s_007">
<h3>Patients and methods</h3>
<p>We used a comprehensive population-based database to identify clinical stage I non-operated NSCLC patients in Taiwan diagnosed from 2007 to 2013 who were treated with either SABR or CFRT. We used inverse probability weighting and the propensity score as the primary form of analysis to address the nonrandomization of treatment. In the supplementary analyses, we constructed subgroups based on propensity score matching to compare survival between patients treated with SABR vs. CFRT.</p></sec>
<sec id="j_raon-2017-0058_s_008">
<h3>Results</h3>
<p>We identified 238 patients in our primary analysis. A good balance of covariates was achieved using the propensity score weighting. Overall survival (OS) was not significantly different between those treated with SABR vs. CFRT (SABR vs. CFRT: probability weighting adjusted hazard ratio [HR] 0.586, 95% confidence interval 0.264–1.101, p = 0.102). However, SABR was significantly favored in supplementary analyses.</p></sec>
<sec id="j_raon-2017-0058_s_009">
<h3>Conclusions</h3>
<p>In this population-based propensity-score adjusted analysis, we found that OS was not significantly different between those treated with SABR <italic>vs</italic>. CFRT in the primary analysis, although significance was observed in the supplementary analyses. Our results should be interpreted with caution given the database (i.e., nonrandomized) approach used in our study. Overall, further studies are required to explore these issues.</p></sec>
</abstract>

Background
Stereotactic ablative radiotherapy (SABR) is a promising option for non-operated early-stage non-small cell lung cancer (NSCLC) compared to conventional fractionated radiotherapy (CFRT). However, results from conclusive randomized controlled trials are not yet available. The aim of our study was to explore the effectiveness of SABR vs. CFRT for non-operated early-stage NSCLC.

Patients and methods
We used a comprehensive population-based database to identify clinical stage I non-operated NSCLC patients in Taiwan diagnosed from 2007 to 2013 who were treated with either SABR or CFRT. We used inverse probability weighting and the propensity score as the primary form of analysis to address the nonrandomization of treatment. In the supplementary analyses, we constructed subgroups based on propensity score matching to compare survival between patients treated with SABR vs. CFRT.

Results
We identified 238 patients in our primary analysis. A good balance of covariates was achieved using the propensity score weighting. Overall survival (OS) was not significantly different between those treated with SABR vs. CFRT (SABR vs. CFRT: probability weighting adjusted hazard ratio [HR] 0.586, 95% confidence interval 0.264–1.101, p = 0.102). However, SABR was significantly favored in supplementary analyses.

Conclusions
In this population-based propensity-score adjusted analysis, we found that OS was not significantly different between those treated with SABR vs. CFRT in the primary analysis, although significance was observed in the supplementary analyses. Our results should be interpreted with caution given the database (i.e., nonrandomized) approach used in our study. Overall, further studies are required to explore these issues.

A population-based study of the effectiveness of stereotactic ablative radiotherapy versus conventional fractionated radiotherapy for clinical stage I non-small cell lung cancer patients

Department of Respiratory Therapy, College of Health Care

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Background
Stereotactic ablative radiotherapy (SABR) is a promising option for non-operated early-stage non-small cell lung cancer (NSCLC) compared to...

A population-based study of the effectiveness of stereotactic ablative radiotherapy versus conventional fractionated radiotherapy for clinical stage I non-small cell lung cancer patients

Article Category: Research Article

Published Online: Dec 07, 2017

Page range: 181 - 188

Received: Jul 28, 2017

Accepted: Sep 18, 2017

DOI: https://doi.org/10.1515/raon-2017-0058

© 2017 Chih-Yen Tu, Te-Chun Hsia, Hsin-Yuan Fang, Ji-An Liang, Su-Tso Yang, Chia-Chin Li, Chun-Ru Chien, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.