CHI St. Luke’s Health–Baylor St. Luke’s Medical Center (Baylor St. Luke’s) participated in the first randomized clinical trial to compare the overall survival rates of Stereotactic Ablative Radiotherapy (SABR) and invasive surgery on patients with operable Stage I Non-Small Cell Lung Cancer (NSCLC). Baylor St. Luke’s CyberKnife® system was used for radiotherapy sessions for patients randomly assigned to receive the SABR treatment.
Findings suggest that SABR treatment should be considered as an alternative to surgery, especially with elderly patients and those with multiple diseases.
“CyberKnife® is a more convenient and effective non-invasive therapy for treating operable early stage lung cancer,” said Steve Carpenter, MD, Radiation Oncology, Baylor St. Luke’s Medical Center. “This approach provides patients with reassurance that there are alternatives to surgery with fewer risks.”
By delivering high doses of radiation to a tumor with extreme accuracy, CyberKnife® is the only radiation treatment device which allows physicians to track the tumor in real-time, as it moves to destroy the tumor with minimal damage to surrounding normal tissue. All other radiation devices for lung cancer unnecessarily treat a larger volume of normal lung tissue. SABR patients who received the treatment, completed therapy within three-to-five visits with no anesthesia, incisions, or risk of infection. Patients were allowed to resume their normal activity following each treatment, while surgical patients faced recovery times of six weeks or longer.
During the clinical trial, 58 patients were enrolled and randomly assigned (31 to SABR and 27 to surgery). Estimated three-year survival rates were 79 percent in the surgery group, and 95 percent in the SABR group. Recurrence-free survival rates at three years were 80 percent and 86 percent, respectively. Six patients in the surgery group died versus one death within the SABR group. None of the patients treated with SABR had high-grade toxicity.
“Prior to the trial, surgery has been the standard treatment for NSCLC. Patients with higher surgical risks were primarily considered for SABR,” said Dr. Carpenter. “Through the findings of our study, SABR proves to be an effective treatment for any patient with early stages of the disease. Physicians can offer patients a non-invasive option that poses less risk of complications and may lead to better survival outcomes.”
Baylor St. Luke’s joined The University of Texas MD Anderson Cancer Center and other hospitals in contributing to this multi-institutional study. The findings from the study were recently published in The Lancet Oncology.