| Stereotactic body radiotherapy versus surgery for medically operable Stage I non-small-cell lung cancer: a Markov model-based decision analysis. | |
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MedLine Citation:
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PMID: 20932688 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To compare the quality-adjusted life expectancy and overall survival in patients with Stage I non-small-cell lung cancer (NSCLC) treated with either stereotactic body radiation therapy (SBRT) or surgery. METHODS AND MATERIALS: We constructed a Markov model to describe health states after either SBRT or lobectomy for Stage I NSCLC for a 5-year time frame. We report various treatment strategy survival outcomes stratified by age, sex, and pack-year history of smoking, and compared these with an external outcome prediction tool (Adjuvant! Online). RESULTS: Overall survival, cancer-specific survival, and other causes of death as predicted by our model correlated closely with those predicted by the external prediction tool. Overall survival at 5 years as predicted by baseline analysis of our model is in favor of surgery, with a benefit ranging from 2.2% to 3.0% for all cohorts. Mean quality-adjusted life expectancy ranged from 3.28 to 3.78 years after surgery and from 3.35 to 3.87 years for SBRT. The utility threshold for preferring SBRT over surgery was 0.90. Outcomes were sensitive to quality of life, the proportion of local and regional recurrences treated with standard vs. palliative treatments, and the surgery- and SBRT-related mortalities. CONCLUSIONS: The role of SBRT in the medically operable patient is yet to be defined. Our model indicates that SBRT may offer comparable overall survival and quality-adjusted life expectancy as compared with surgical resection. Well-powered prospective studies comparing surgery vs. SBRT in early-stage lung cancer are warranted to further investigate the relative survival, quality of life, and cost characteristics of both treatment paradigms. |
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Authors:
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Alexander V Louie; George Rodrigues; Malek Hannouf; Gregory S Zaric; David A Palma; Jeffrey Q Cao; Brian P Yaremko; Richard Malthaner; Joseph D Mocanu |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2010-10-06 |
Journal Detail:
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Title: International journal of radiation oncology, biology, physics Volume: 81 ISSN: 1879-355X ISO Abbreviation: Int. J. Radiat. Oncol. Biol. Phys. Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-10-31 Completed Date: 2012-01-06 Revised Date: 2012-02-17 |
Medline Journal Info:
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Nlm Unique ID: 7603616 Medline TA: Int J Radiat Oncol Biol Phys Country: United States |
Other Details:
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Languages: eng Pagination: 964-73 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Oncology, University of Western Ontario, London, ON, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Carcinoma, Non-Small-Cell Lung / mortality, pathology, surgery* Cause of Death Decision Support Techniques* Female Humans Life Expectancy Lung Neoplasms / mortality, pathology, surgery* Male Markov Chains* Neoplasm Staging Pneumonectomy / methods*, mortality Quality of Life Quality-Adjusted Life Years Radiosurgery / methods*, mortality Reproducibility of Results Salvage Therapy / methods Sensitivity and Specificity Sex Factors Smoking |
| Comments/Corrections | |
Comment In:
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Int J Radiat Oncol Biol Phys. 2012 Feb 1;82(2):522; author reply 523
[PMID:
22244284
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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