Patient-reported Outcomes After the Treatment of Early Stage Non–small-cell Lung Cancer With Stereotactic Body Radiotherapy Compared With Surgery

Leonie Alberts, Henri B. Wolff, Elisabeth A. Kastelijn, Frank J. Lagerwaard, Frederik N. Hofman, Sherif Y. El Sharouni, Franz M. N. H. Schramel, Veerle M. H. Coupe

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction: As there is increasing evidence for comparable survival after either stereotactic body radiotherapy (SBRT) or surgery for patients with stage I non–small-cell lung cancer (NSCLC), treatment impact on the quality of life (QoL) is essential for well-informed decision-making. Our previous work evaluated health utility between surgery and SBRT in stage I NSCLC. The aim of this secondary analysis is to directly compare QoL in the first year after SBRT and surgery. Materials and Methods: QoL was assessed at baseline and 3, 6, and 12 months after treatment. Two prospectively collected databases of patients with clinically proven stage I NSCLC, from 2 large hospitals in the Netherlands, were pooled (n = 306; 265 patients were treated with SBRT and 41 patients with surgery). To correct for confounding, propensity scores were calculated, to be selected for surgical treatment. A mixed model analysis was used to study differences in QoL between the 2 treatments. Results: The 41 surgical patients were matched to 41 SBRT patients on propensity score with a 1:1 ratio. At baseline, patients in the surgery group report a lower QoL compared with patients in the SBRT group. However, during the first year after treatment, no clinical meaningful differences were observed, except for role functioning, between patients treated using either modality. Conclusion: This study comparing a matched cohort revealed no clinically significant differences in QoL following either SBRT or surgery for early stage NSCLC. These results support the hypothesis that surgery and SBRT are comparable treatments. Quality of life is an important factor in deciding between stereotactic body radiotherapy and surgery when the expected difference in survival benefit is very small. This Dutch direct comparison of 41 patients treated with stereotactic body radiotherapy and 41 with surgery, revealed no clinical significant differences in quality of life the first year after treatment.

Original languageEnglish
Pages (from-to)370-377.e3
JournalClinical Lung Cancer
Volume20
Issue number5
DOIs
Publication statusPublished - 1 Sep 2019

Cite this

Alberts, Leonie ; Wolff, Henri B. ; Kastelijn, Elisabeth A. ; Lagerwaard, Frank J. ; Hofman, Frederik N. ; Sharouni, Sherif Y. El ; Schramel, Franz M. N. H. ; Coupe, Veerle M. H. / Patient-reported Outcomes After the Treatment of Early Stage Non–small-cell Lung Cancer With Stereotactic Body Radiotherapy Compared With Surgery. In: Clinical Lung Cancer. 2019 ; Vol. 20, No. 5. pp. 370-377.e3.
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title = "Patient-reported Outcomes After the Treatment of Early Stage Non–small-cell Lung Cancer With Stereotactic Body Radiotherapy Compared With Surgery",
abstract = "Introduction: As there is increasing evidence for comparable survival after either stereotactic body radiotherapy (SBRT) or surgery for patients with stage I non–small-cell lung cancer (NSCLC), treatment impact on the quality of life (QoL) is essential for well-informed decision-making. Our previous work evaluated health utility between surgery and SBRT in stage I NSCLC. The aim of this secondary analysis is to directly compare QoL in the first year after SBRT and surgery. Materials and Methods: QoL was assessed at baseline and 3, 6, and 12 months after treatment. Two prospectively collected databases of patients with clinically proven stage I NSCLC, from 2 large hospitals in the Netherlands, were pooled (n = 306; 265 patients were treated with SBRT and 41 patients with surgery). To correct for confounding, propensity scores were calculated, to be selected for surgical treatment. A mixed model analysis was used to study differences in QoL between the 2 treatments. Results: The 41 surgical patients were matched to 41 SBRT patients on propensity score with a 1:1 ratio. At baseline, patients in the surgery group report a lower QoL compared with patients in the SBRT group. However, during the first year after treatment, no clinical meaningful differences were observed, except for role functioning, between patients treated using either modality. Conclusion: This study comparing a matched cohort revealed no clinically significant differences in QoL following either SBRT or surgery for early stage NSCLC. These results support the hypothesis that surgery and SBRT are comparable treatments. Quality of life is an important factor in deciding between stereotactic body radiotherapy and surgery when the expected difference in survival benefit is very small. This Dutch direct comparison of 41 patients treated with stereotactic body radiotherapy and 41 with surgery, revealed no clinical significant differences in quality of life the first year after treatment.",
keywords = "Lung resection, QoL, Quality of life, SABR, Shared decision",
author = "Leonie Alberts and Wolff, {Henri B.} and Kastelijn, {Elisabeth A.} and Lagerwaard, {Frank J.} and Hofman, {Frederik N.} and Sharouni, {Sherif Y. El} and Schramel, {Franz M. N. H.} and Coupe, {Veerle M. H.}",
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Patient-reported Outcomes After the Treatment of Early Stage Non–small-cell Lung Cancer With Stereotactic Body Radiotherapy Compared With Surgery. / Alberts, Leonie; Wolff, Henri B.; Kastelijn, Elisabeth A.; Lagerwaard, Frank J.; Hofman, Frederik N.; Sharouni, Sherif Y. El; Schramel, Franz M. N. H.; Coupe, Veerle M. H.

In: Clinical Lung Cancer, Vol. 20, No. 5, 01.09.2019, p. 370-377.e3.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Patient-reported Outcomes After the Treatment of Early Stage Non–small-cell Lung Cancer With Stereotactic Body Radiotherapy Compared With Surgery

AU - Alberts, Leonie

AU - Wolff, Henri B.

AU - Kastelijn, Elisabeth A.

AU - Lagerwaard, Frank J.

AU - Hofman, Frederik N.

AU - Sharouni, Sherif Y. El

AU - Schramel, Franz M. N. H.

AU - Coupe, Veerle M. H.

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Y1 - 2019/9/1

N2 - Introduction: As there is increasing evidence for comparable survival after either stereotactic body radiotherapy (SBRT) or surgery for patients with stage I non–small-cell lung cancer (NSCLC), treatment impact on the quality of life (QoL) is essential for well-informed decision-making. Our previous work evaluated health utility between surgery and SBRT in stage I NSCLC. The aim of this secondary analysis is to directly compare QoL in the first year after SBRT and surgery. Materials and Methods: QoL was assessed at baseline and 3, 6, and 12 months after treatment. Two prospectively collected databases of patients with clinically proven stage I NSCLC, from 2 large hospitals in the Netherlands, were pooled (n = 306; 265 patients were treated with SBRT and 41 patients with surgery). To correct for confounding, propensity scores were calculated, to be selected for surgical treatment. A mixed model analysis was used to study differences in QoL between the 2 treatments. Results: The 41 surgical patients were matched to 41 SBRT patients on propensity score with a 1:1 ratio. At baseline, patients in the surgery group report a lower QoL compared with patients in the SBRT group. However, during the first year after treatment, no clinical meaningful differences were observed, except for role functioning, between patients treated using either modality. Conclusion: This study comparing a matched cohort revealed no clinically significant differences in QoL following either SBRT or surgery for early stage NSCLC. These results support the hypothesis that surgery and SBRT are comparable treatments. Quality of life is an important factor in deciding between stereotactic body radiotherapy and surgery when the expected difference in survival benefit is very small. This Dutch direct comparison of 41 patients treated with stereotactic body radiotherapy and 41 with surgery, revealed no clinical significant differences in quality of life the first year after treatment.

AB - Introduction: As there is increasing evidence for comparable survival after either stereotactic body radiotherapy (SBRT) or surgery for patients with stage I non–small-cell lung cancer (NSCLC), treatment impact on the quality of life (QoL) is essential for well-informed decision-making. Our previous work evaluated health utility between surgery and SBRT in stage I NSCLC. The aim of this secondary analysis is to directly compare QoL in the first year after SBRT and surgery. Materials and Methods: QoL was assessed at baseline and 3, 6, and 12 months after treatment. Two prospectively collected databases of patients with clinically proven stage I NSCLC, from 2 large hospitals in the Netherlands, were pooled (n = 306; 265 patients were treated with SBRT and 41 patients with surgery). To correct for confounding, propensity scores were calculated, to be selected for surgical treatment. A mixed model analysis was used to study differences in QoL between the 2 treatments. Results: The 41 surgical patients were matched to 41 SBRT patients on propensity score with a 1:1 ratio. At baseline, patients in the surgery group report a lower QoL compared with patients in the SBRT group. However, during the first year after treatment, no clinical meaningful differences were observed, except for role functioning, between patients treated using either modality. Conclusion: This study comparing a matched cohort revealed no clinically significant differences in QoL following either SBRT or surgery for early stage NSCLC. These results support the hypothesis that surgery and SBRT are comparable treatments. Quality of life is an important factor in deciding between stereotactic body radiotherapy and surgery when the expected difference in survival benefit is very small. This Dutch direct comparison of 41 patients treated with stereotactic body radiotherapy and 41 with surgery, revealed no clinical significant differences in quality of life the first year after treatment.

KW - Lung resection

KW - QoL

KW - Quality of life

KW - SABR

KW - Shared decision

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