Survival of patients with stage 1 non-small cell lung cancer (NSCLC) is similar after thermal ablation and stereotactic radiation therapy, respectively, according to data from the U.S. National Cancer Database.
"Our study adds thermal-ablation treatment as an effective treatment method for early lung cancer patients," said Dr. Hyun S. "Kevin" Kim from Yale Cancer Center, in New Haven, Connecticut.
"This is a real value to our patients, especially as it affords an opportunity for tissue sampling at the same time, important in personalized precision cancer treatments," said Kevin.
Thermal ablation (TA) and stereotactic radiation therapy (SRT)
Thermal ablation (TA) and stereotactic radiation therapy (SRT) have emerged as local treatment options for patients with early-stage NSCLC who are ineligible or unwilling to undergo surgery.
Dr. Kim and colleagues evaluated the use of TA for the treatment of stage 1 NSCLC and analyzed its effectiveness in comparison to SRT in a retrospective study of more than 28,000 patients (1,102 treated with TA and 27,732 treated with SRT).
The researchers created a matched group of 1,070 pairs of patients, based on their propensity to undergo TA treatment, and these patients were followed an average 52.4 months.
Overall survival in the matched cohort did not differ significantly between patients who underwent TA and those who suffered SRT. At one year, they were 85.4% and 86.3%, respectively; at two, 65.2% and 64.5%; at three, 47.8% and 45.9%; and at five, 24.6% and 26.1%, the researchers report in Radiology, online September 18.
Median overall survival did not differ between the TA (34.3 months) and SRT (33.7 months) groups. But the 30-day posttreatment unplanned hospital readmission rate was significantly higher after TA (3.7%) than after SRT (0.2%).
"We plan to continue studying thermal ablation to see how it would best fit in the total care in patients with lung cancer by investigating biomarkers, radio-genomics, and immuno-oncology, for instance, in combination with the promising field of immunotherapy in advanced stage lung cancers," Dr. Kim said.
Dr. Calvin S. H. Ng from The Chinese University of Hong Kong, who studies treatments for early-stage lung cancer, said, "The gold standard for treatment of resectable stage 1 NSCLC remains surgical resection, preferably by the minimally invasive approach."
"For patients unable to have surgery or who elect not to have surgery, SRT has been the favored alternative, given that its treatment efficacy has the most data to support its use," said Ng.
"However, as we can see from this study, there is now increasing data to support thermal ablation as a good alternative to SRT even for those with high or higher co-morbidities," said Ng.