A single-centre experience of SBRT and EBRT in Stage I NSCLC patients: Local failure and survival

Purpose or Objective Stereotactic Body Radiotherapy (SBRT) has become the standard radiation therapy for inoperable stage I nonsmall cell lung cancer (NSCLC) patients. We analyse retrospectively the results of survival and local control in two series of 25 and 48 patients treated with conventional radiation therapy (EBRT) and stereotactic body radiotherapy respectively at our centre. Material and Methods From May 2006 to February 2010, 90 patients were treated with EBRT (66Gy, 33 fractions) inside a Spanish national phase II trial which compared EBRT against EBRT combined with erlotinib. At our centre, 25 patients were stage I NSCLC (13 had treatment combined with erlotinib, 52%). All of them had histological proven NSCLC T1- T2aN0M0. After its introduction in 2011, SBRT became the standard treatment for this group of patients. From August 2011 to September 2016, 48 patients were treated with SBRT (48-60Gy in 3-8 fractions), only 26 with NSCLC histological confirmation (55.2%). We compared retrospectively both local control and overall survival (OS) for these two groups of patients using Kaplan Meier from SPSS20. Results Local control at 1-year in SBRT group was 97.5% versus 65.4% in the EBRT group and at 3-years 87.8% versus 45%, respectively (p < 0.05). The median OS was 31.5 months versus 15 months for SBRT and EBRT, respectively, with an OS of 81% and 64% for SBRT and EBRT at 1- year respectively, and at 3-year 56% and 4% (p<0.05). Conclusion We found a significant difference in local control and overall survival favouring stage I NSCLC patients treated with SBRT. Although staging procedure and technical improvements of radiation treatment could influence our results, SBRT has proven to be more efficient in local control and overall survival than EBRT. (Figure Presented).