Sublobar Resection or SBRT: Are There Quality-of-Life Differences for Patients With Early-Stage Lung Cancer?

A new study suggests that sublobar resection or stereotactic body radiation therapy (SBRT) have similar impacts on quality of life (QOL) for patients with early-stage lung cancer who are not candidates for lobectomy.

Jeremy Mudd, MD, of the Icahn School of Medicine at Mount Sinai, and colleagues conducted the study and presented their findings during the American Thoracic Society 2024 International Conference.

It was important to conduct the research because there is “limited information about the trajectory of patient-centered outcomes” following SBRT or sublobar resection in patients with early-stage lung cancer who are not candidates for lobectomy. Dr. Mudd and colleagues recruited 337 patients with clinical stage I-IIA non-small cell lung cancer who were at high risk for lobectomy complications and received treatment with sublobar resection (37%) or SBRT (63%). The patients were recruited from 5 distinct health care systems.

The researchers compared QOL as measured by the Short Form-8 (SF-8) for physical and mental health and the Functional Assessment of Cancer Therapy-Lung (FACT-L) survey of lung cancer-specific QOL. Both tools are Likert scales, and scores range from 0 to 100 for the SF-8 measure of physical and mental health and 0 to 28 for FACT-L. On both measures, higher scores equate to better QOL. Dr. Mudd and colleagues administered the instruments before treatment and at 7 days, 30 days, 6 months, and 12 months after sublobar resection or SBRT. The researchers used inverse probability of treatment weighting to control for confounds.

At 7 days after treatment, patients who received SBRT had higher physical health scores on the SF-8 measure (difference in differences [DID], 6.42; P=.0008) and a higher score on the FACT-L compared with those who received sublobar resection (DID, 2.47; P=.004). However, there were no significant differences in QOL at later time points for any measurements, and all QOL scores returned to baseline levels by 12 months after treatment in both groups of patients.

“SBRT is associated with better QOL in the early post-treatment period compared with sublobar resection,” Dr. Mudd and colleagues concluded. “However, both treatment groups reported similar QOL at later timepoints, with return to baseline QOL by study’s end. These findings suggest that sublobar resection and SBRT have a similar impact on QOL of early-stage lung cancer patients [who] are not good candidates for lobectomy.”

Reference

Mudd J, Wisnivesky JP, Stone K, et al. Longitudinal quality of life following sub-lobar resection and stereotactic body radiation therapy for early-stage non-small cell lung cancer. Presented at the American Thoracic Society 2024 International Conference; May 17-22, 2024; San Diego, California.