Comparative analysis of clinical efficacy between stereotactic ablative radiotherapy and surgery for early-stage non-small cell lung cancer

Objective: To compare the clinical efficacy and safety between stereotactic ablative radiotherapy (SABR) and surgery in the treatment of early-stage non-small cell lung cancer (NSCLC). Methods: A total of 227 patients who were initially diagnosed with early-stage NSCLC and with complete clinical data admitted to Henan Cancer Hospital between June 2012 and December 2016 were recruited and assigned into the SABR (n = 73) and surgery groups (n = 154). Kaplan-Meier method was used to calculate survival rate and survival comparison was performed using the log-rank test. Chi-square test was adopted to compare the baseline data between two groups. Results: All patients completed corresponding treatment. The samples of SABR group and operation group were 74 and 155 cases respectively. The 1-year and 3-year overall survival (OS) rates in the SABR and surgery groups were 97.2%, 81.9% and 96.5%, 78.2% (P = 0.603), respectively. The 1-year and 3-year progression-free survival (PFS) rates in the SABR and surgery groups were 90.1%, 66.9% and 89.2%, 66.9% (P = 0.565), respectively. The 1-year and 3-year locoregional recurrence free survival rates in the SABR and surgery groups were 92.8%, 84.0% and 96.5%, 90.8% (P = 0.133), respectively. The 1-year and 3-year distant metastasis-free survival rates in the SABR and surgery groups were 97.2%, 75.4% and 89.2%, 69.8% (P = 0.095), respectively. Conclusions: SABR and surgery yield similar OS, PFS, locoregional recurrence-free and distant metastasis-free survival rates in the treatment of early-stage NSCLC. Therefore, SABR is an alternative treatment for patients with early-stage NSCLC. (authors)