Limited resection followed by intraoperative seed implantation is comparable to stereotactic body radiotherapy for solitary lung cancer

Abstract

BACKGROUND:The objective of this study was to compare the outcomes of patients who underwent wedge resection plus intraoperative brachytherapy versus patients who received stereotactic body radiotherapy (SBRT) for single malignant lung nodules. METHODS: A retrospective chart review included 55 patients who were treated for single lung nodules, and 47 of those patients who had adequate information were chosen for the current analysis. Twentyfive patients with single malignant lung nodules received SBRT. Twenty-two patients underwent limited surgical resection plus radioactive seed implantation for solitary malignant lung nodules. RESULTS: Univariate statistical analysis demonstrated a significance difference only for age in the 2 groups: The mean age in the radioactive seed group (66.6 years) was statistically significantly different from the mean of the age in the SBRT group (75.9 years; 2-sided P ¼ .04). No significant differences were observed between the 2 groups in terms of local control, distant metastasis, survival, or toxicity. CONCLUSIONS: The current results demonstrated comparable efficacy in outcome and toxicity between surgical resection with radioactive seed implantation and SBRT for the treatment of single malignant lung nodules in patients who were not candidates for lobectomy/pneumonectomy. Cancer 2010;116:5047-53.

Comparison of long-term survival outcomes between stereotactic body radiotherapy and sublobar resection for stage I non-small-cell lung cancer in patients at high risk for lobectomy: A propensity score matching analysis

“…With a median potential follow-up of 2.5 years, OS was higher after wedge resection, but cause-specific survival (CSS) was identical. Parashar et al reported no significant difference in local control, DM, OS or toxicity between 47 patients who underwent SBRT or SLR followed by radioactive seed implantation based on a mean followup of 1.5 years [28]. No matching method was applied in these two studies.…”

Primary Treatment Options for High-Risk/Medically Inoperable Early Stage NSCLC Patients

“…Intraoperative brachytherapy has the potential to improve LC following limited resection of early-stage NSCLC 38-40 . Such low dose-rate (LDR) brachytherapy techniques permit delivery of radiation doses to the high-risk surgical bed over a period of weeks to months with the additional advantages of predictable, focal, and highly conformal dose-distribution with decreased side-effects due to reduction of the irradiated normal tissue volume 41 .…”

“…Parashar and colleagues 38 retrospectively reviewed 47 patients who underwent wedge resection and intraoperative brachytherapy versus stereotactic body radiotherapy (SBRT) alone for treatment of a single malignant lung nodule. Twenty-two patients were treated with brachytherapy following resection and 25 patients with SBRT alone.…”

Management of Single Malignant Lung Nodules in Elderly Patients (70 Years or Older) Who are Not Candidates for Lobectomy

“…We recently published a study comparing SBRT and IOS in all patients treated at our institution but the study included patients younger than 70 years and with a shorter follow-up. 32 This report evaluates and compares the 2 nonlobectomy treatment modalities in the elderly patients (70 y or higher). Depending on the availability of the technology and the experts of the treating physicians, either treatment can be offered.…”