Stereotactic body radiation therapy (SBRT) improves local control and overall survival compared to conventionally fractionated radiation for stage I non-small cell lung cancer (NSCLC)

Figures & data

Table 1. Patient characteristics.

Factor	Conventional, n = 127, n (%)	SBRT, n = 398, n (%)	p-value
Median age (range)	74 (46–93)	77 (50–95)	.060
Gender			.11
Male	69 (54)	182 (46)
Female	58 (46)	216 (54)
KPS			.058
<80	47 (37)	110 (28)
≥80	80 (63)	288 (72)
History of smoking			.005
Never	10 (8)	34 (9)
Former	91 (72)	326 (82)
Current	26 (20)	38 (10)
T stage			<.001
T1	66 (52)	321 (81)
T2	61 (48)	77 (19)
Histology			<.001
Adenocarcinoma	77 (61)	283 (71)
Squamous cell	32 (25)	101 (25)
NSCLC NOS	18 (14)	14 (4)
PET staging			<.0001
Yes	96 (76)	388 (97)
No	31 (24)	10 (3)
Median radiation dose (Gy, range)	75.6 (60–90)	48 (45–60)
Median BED (Gy, range)	89.2 (72.0–108.0)	105.6 (85.5–180.0)	<.001

Figure 1. Cumulative incidence of local failure (a) CONV versus SBRT, (b) adenocarcinoma versus squamous cell and (c) T1 versus T2.

Table 2. UVA/MVA for local failure.

Factor	UVA		MVA
	Hazard ratio (95% CI)	p-value	Hazard ratio (95% CI)	p-value
SBRT versus CONV	0.29 (0.19, 0.43)	<.001	0.42 (0.25, 0.70)	<.001
Gender (F versus M)	0.59 (0.39, 0.90)	.014	0.63 (0.40, 0.997)	.049
Histology (squamous versus adeno, n = 493)	2.17 (1.40, 3.35)	<.001	2.24 (1.42, 3.55)	<.001
T stage (T2 versus T1)	2.58 (1.72, 3.88)	<.001	1.63 (1.02, 2.62)	.04
BED (Gy, continuous)	0.98 (0.97, 0.99)	<.001	0.993 (0.984, 1.002)	.14
Age (continuous)	1.01 (0.98, 1.03)	.63
KPS (≥80 versus <80)	1.22 (0.77, 1.93)	.39
Smoking (former versus never)	0.66 (0.36, 1.24)	.20	0.63 (0.31, 1.27)	.20
Smoking (current versus never)	0.44 (0.18, 1.09)	.076	0.45 (0.17, 1.19)	.11

Figure 2. Overall survival probability (a) CONV versus SBRT, (b) adenocarcinoma versus squamous cell, and (c) T1 versus T2.

Table 3. UVA/MVA for overall survival.

Factor	UVA		MVA
	Hazard ratio (95% CI)	p-value	Hazard ratio (95% CI)	p-value
SBRT versus CONV	0.73 (0.57, 0.95)	.018	0.77 (0.55, 1.06)	.10
Age (continuous)	1.03 (1.01, 1.04)	<.001	1.03 (1.02, 1.05)	<.001
KPS (≥80 versus <80)	0.62 (0.49, 0.80)	<.001	0.66 (0.51, 0.85)	.002
Histology (squamous versus adeno, n = 493)	1.63 (1.25, 2.12)	<.001	1.58 (1.20, 2.07)	.001
T stage (T2 versus T1)	1.80 (1.40, 2.31)	<.001	1.38 (1.03, 1.85)	.03
BED (Gy, continuous)	0.9959 (0.9922, 0.9996)	.028	0.999 (0.995, 1.004)	.70
Smoking (former versus never)	1.12 (0.73, 1.71)	.61
Smoking (current versus never)	0.89 (0.53, 1.49)	.65
Gender (F versus M)	1.06 (0.83, 1.35)	.63