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Stereotactic Body Radiotherapy Versus Delayed Surgery for Early-stage Non-small-cell Lung Cancer.

Identifieur interne : 000264 ( Main/Exploration ); précédent : 000263; suivant : 000265

Stereotactic Body Radiotherapy Versus Delayed Surgery for Early-stage Non-small-cell Lung Cancer.

Auteurs : Nicholas R. Mayne [États-Unis] ; Belle K. Lin [États-Unis] ; Alice J. Darling [États-Unis] ; Vignesh Raman [États-Unis] ; Deven C. Patel [États-Unis] ; Douglas Z. Liou [États-Unis] ; Thomas A. D'Amico [États-Unis] ; Chi-Fu Jeffrey Yang [États-Unis]

Source :

RBID : pubmed:33074904

Descripteurs français

English descriptors

Abstract

OBJECTIVE

To evaluate the overall survival of patients with operable stage IA non-small-cell lung cancer (NSCLC) who undergo "early" SBRT (within 0-30 days after diagnosis) versus "delayed" surgery (90-120 days after diagnosis).

SUMMARY OF BACKGROUND DATA

During the COVID-19 pandemic, national guidelines have recommended patients with operable stage IA NSCLC to consider delaying surgery by at least 3 months or, alternatively, to undergo SBRT without delay. It is unknown which strategy is associated with better short- and long-term outcomes.

METHODS

Multivariable Cox proportional hazards modeling and propensity score-matched analysis was used to compare the overall survival of patients with stage IA NSCLC in the National Cancer Data Base from 2004 to 2015 who underwent "early" SBRT (0-30 days after diagnosis) versus that of patients who underwent "delayed" wedge resection (90-120 days after diagnosis).

RESULTS

During the study period, 570 (55%) patients underwent early SBRT and 475 (45%) underwent delayed wedge resection. In multivariable analysis, delayed resection was associated with improved survival [adjusted hazard ratio 0.61; (95% confidence interval (CI): 0.50-0.76)]. Propensity-score matching was used to create 2 groups of 279 patients each who received early SBRT or delayed resection that were well-matched with regard to baseline characteristics. The 5-year survival associated with delayed resection was 53% (95% CI: 45%-61%) which was better than the 5-year survival associated with early SBRT (31% [95% CI: 24%-37%]).

CONCLUSION

In this national analysis, for patients with stage IA NSCLC, extended delay of surgery was associated with improved survival when compared to early treatment with SBRT.


DOI: 10.1097/SLA.0000000000004363
PubMed: 33074904
PubMed Central: PMC7668323


Affiliations:


Links toward previous steps (curation, corpus...)


Le document en format XML

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<term>Carcinoma, Non-Small-Cell Lung (mortality)</term>
<term>Carcinoma, Non-Small-Cell Lung (pathology)</term>
<term>Carcinoma, Non-Small-Cell Lung (radiotherapy)</term>
<term>Carcinoma, Non-Small-Cell Lung (surgery)</term>
<term>Cohort Studies (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Lung Neoplasms (mortality)</term>
<term>Lung Neoplasms (pathology)</term>
<term>Lung Neoplasms (radiotherapy)</term>
<term>Lung Neoplasms (surgery)</term>
<term>Neoplasm Staging (MeSH)</term>
<term>Radiosurgery (MeSH)</term>
<term>SARS-CoV-2 (MeSH)</term>
<term>Survival Rate (MeSH)</term>
<term>Time Factors (MeSH)</term>
<term>Time-to-Treatment (MeSH)</term>
</keywords>
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<term>Carcinome pulmonaire non à petites cellules (anatomopathologie)</term>
<term>Carcinome pulmonaire non à petites cellules (chirurgie)</term>
<term>Carcinome pulmonaire non à petites cellules (mortalité)</term>
<term>Carcinome pulmonaire non à petites cellules (radiothérapie)</term>
<term>Délai jusqu'au traitement (MeSH)</term>
<term>Facteurs temps (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Radiochirurgie (MeSH)</term>
<term>Stadification tumorale (MeSH)</term>
<term>Taux de survie (MeSH)</term>
<term>Tumeurs du poumon (anatomopathologie)</term>
<term>Tumeurs du poumon (chirurgie)</term>
<term>Tumeurs du poumon (mortalité)</term>
<term>Tumeurs du poumon (radiothérapie)</term>
<term>Études de cohortes (MeSH)</term>
</keywords>
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<term>Carcinome pulmonaire non à petites cellules</term>
<term>Tumeurs du poumon</term>
</keywords>
<keywords scheme="MESH" qualifier="chirurgie" xml:lang="fr">
<term>Carcinome pulmonaire non à petites cellules</term>
<term>Tumeurs du poumon</term>
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<term>Carcinoma, Non-Small-Cell Lung</term>
<term>Lung Neoplasms</term>
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<term>Carcinome pulmonaire non à petites cellules</term>
<term>Tumeurs du poumon</term>
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<term>Lung Neoplasms</term>
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<term>Carcinoma, Non-Small-Cell Lung</term>
<term>Lung Neoplasms</term>
</keywords>
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<term>Carcinome pulmonaire non à petites cellules</term>
<term>Tumeurs du poumon</term>
</keywords>
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</keywords>
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<term>COVID-19</term>
<term>Cohort Studies</term>
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<term>Neoplasm Staging</term>
<term>Radiosurgery</term>
<term>SARS-CoV-2</term>
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<term>Facteurs temps</term>
<term>Humains</term>
<term>Radiochirurgie</term>
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<p>
<b>OBJECTIVE</b>
</p>
<p>To evaluate the overall survival of patients with operable stage IA non-small-cell lung cancer (NSCLC) who undergo "early" SBRT (within 0-30 days after diagnosis) versus "delayed" surgery (90-120 days after diagnosis).</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>SUMMARY OF BACKGROUND DATA</b>
</p>
<p>During the COVID-19 pandemic, national guidelines have recommended patients with operable stage IA NSCLC to consider delaying surgery by at least 3 months or, alternatively, to undergo SBRT without delay. It is unknown which strategy is associated with better short- and long-term outcomes.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>Multivariable Cox proportional hazards modeling and propensity score-matched analysis was used to compare the overall survival of patients with stage IA NSCLC in the National Cancer Data Base from 2004 to 2015 who underwent "early" SBRT (0-30 days after diagnosis) versus that of patients who underwent "delayed" wedge resection (90-120 days after diagnosis).</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>During the study period, 570 (55%) patients underwent early SBRT and 475 (45%) underwent delayed wedge resection. In multivariable analysis, delayed resection was associated with improved survival [adjusted hazard ratio 0.61; (95% confidence interval (CI): 0.50-0.76)]. Propensity-score matching was used to create 2 groups of 279 patients each who received early SBRT or delayed resection that were well-matched with regard to baseline characteristics. The 5-year survival associated with delayed resection was 53% (95% CI: 45%-61%) which was better than the 5-year survival associated with early SBRT (31% [95% CI: 24%-37%]).</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSION</b>
</p>
<p>In this national analysis, for patients with stage IA NSCLC, extended delay of surgery was associated with improved survival when compared to early treatment with SBRT.</p>
</div>
</front>
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<AbstractText Label="OBJECTIVE">To evaluate the overall survival of patients with operable stage IA non-small-cell lung cancer (NSCLC) who undergo "early" SBRT (within 0-30 days after diagnosis) versus "delayed" surgery (90-120 days after diagnosis).</AbstractText>
<AbstractText Label="SUMMARY OF BACKGROUND DATA">During the COVID-19 pandemic, national guidelines have recommended patients with operable stage IA NSCLC to consider delaying surgery by at least 3 months or, alternatively, to undergo SBRT without delay. It is unknown which strategy is associated with better short- and long-term outcomes.</AbstractText>
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<AbstractText Label="RESULTS">During the study period, 570 (55%) patients underwent early SBRT and 475 (45%) underwent delayed wedge resection. In multivariable analysis, delayed resection was associated with improved survival [adjusted hazard ratio 0.61; (95% confidence interval (CI): 0.50-0.76)]. Propensity-score matching was used to create 2 groups of 279 patients each who received early SBRT or delayed resection that were well-matched with regard to baseline characteristics. The 5-year survival associated with delayed resection was 53% (95% CI: 45%-61%) which was better than the 5-year survival associated with early SBRT (31% [95% CI: 24%-37%]).</AbstractText>
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