Stereotactic body radiation therapy versus sublobar resection for stage I NSCLC

Ackerson, Bradley G.; Tong, Betty C.; Hong, Julian C.; Gu, Lin; Chino, Junzo; Trotter, Jacob; D’Amico, Thomas A.; Torok, Jordan A.; Lafata, Kyle; Chang, Catherine; Kelsey, Chris R.

doi:10.1016/j.lungcan.2018.09.020

Cited by 27 publications

(26 citation statements)

References 27 publications

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“…Although current treatment guidelines do not recommend SABR as first-line treatment for NSCLC moderate risk patients(1), multiple observational studies have suggested therapeutic equipoise exists between SABR and surgery in those patients with multiple comorbidities (8,9). The lack of long term QoL data from these two treatments has highlighted the importance of understanding whether a truly informed "shared treatment decision" between patients and clinicians can be made.…”

Section: Introductionmentioning

confidence: 99%

Patients’ confidence in treatment decisions for early stage non-small cell lung cancer (NSCLC)

Pompili

Holch

Rogers

et al. 2020

Preprint

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Background In early-stage Non-Small Cell Lung Cancer (NSCLC) patients, little is known about how to measure patient participation in Shared-Decision Making (SDM). We examined the psychometric properties and clinical acceptability of the Decision Self-Efficacy scale (DSE) in a cohort of patients undergoing to Stereotactic Ablative Radiotherapy (SABR) or Video-assisted Thoracoscopic Surgery (VATS) to capture patient involvement in treatment decisions. Methods In the context of a prospective longitudinal study (Life after Lung Cancer-LiLAC) involving 244 patients with early-stage NSCLC, 158 (64.7%) patients completed the DSE either on paper or electronically online prior to treatment with SABR or VATS pulmonary resection. DSE psychometric properties were examined using: principal components analysis of item properties and internal structure, and internal construct validity; we also performed a sensitivity analysis according to Karnofsky Performance Status, gender, age and treatment received (VATS or SABR) difference. Results Two subscales within the DSE were identified: the main factor accounting for almost 72% of the variance related to overcoming barriers to decision making (seven items) and a second factor explaining an additional 9.1% of the variance was related to information seeking processes (four items). We calculated a value of 0.96 for Cronbach’s alpha for the total DSE score, 0.94 for Factor 1 and 0.95 for Factor 2. DSE scores did not differ by gender ( p =0.37), between the two treatment groups (p=0.09) and between younger and older patients ( p =0.4). However, patients with a Karnofsky performance score (PS) >1 have a DSE mean of 73.8 (SD 26) compared to patients with a PS 0-1 who have a DSE mean of 85.8 (SD 20.3 p =0.002). Conclusion Findings provide preliminary evidence for the reliability and validity of the DSE questionnaire in this population. However, future studies are warranted to identify the most appropriate SDM tool for clinical practice in the lung cancer treatment field.

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Section: Introductionmentioning

confidence: 99%

Patients’ confidence in treatment decisions for early stage non-small cell lung cancer (NSCLC)

Pompili

Holch

Rogers

et al. 2020

Preprint

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“…For a decade, stereotactic body radiotherapy (SBRT) has been the standard treatment for these patients. [3][4][5][6] Compared with the conventional method, the major feature of SBRT is the delivery of high doses to the target in a few fractions, resulting in a high biologically effective dose (BED). Although the treatment response of SBRT is comparable with surgery, several patients develop local recurrence (LR) and distant metastasis (DM).…”

Section: Introductionmentioning

confidence: 99%

“…However, many patients cannot undergo surgery because they are at high risk or medically inoperable owing to old age or poor condition, or they are unable to accept associated surgery risks. For a decade, stereotactic body radiotherapy (SBRT) has been the standard treatment for these patients 3–6 . Compared with the conventional method, the major feature of SBRT is the delivery of high doses to the target in a few fractions, resulting in a high biologically effective dose (BED).…”

Section: Introductionmentioning

confidence: 99%

Application and limitation of radiomics approach to prognostic prediction for lung stereotactic body radiotherapy using breath‐hold CT images with random survival forest: A multi‐institutional study

et al. 2020

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Purpose: To predict local recurrence (LR) and distant metastasis (DM) in early stage non-small cell lung cancer (NSCLC) patients after stereotactic body radiotherapy (SBRT) in multiple institutions using breath-hold computed tomography (CT)-based radiomic features with random survival forest. Methods: A total of 573 primary early stage NSCLC patients who underwent SBRT between January 2006 and March 2016 and met the eligibility criteria were included in this study. Patients were divided into two datasets: training (464 patients in 10 institutions) and test (109 patients in one institution) datasets. A total of 944 radiomic features were extracted from manually segmented gross tumor volumes (GTVs). Feature selection was performed by analyzing inter-segmentation reproducibility, GTV correlation, and inter-feature redundancy. Nine clinical factors, including histology and GTV size, were also used. Three prognostic models (clinical, radiomic, and combined) for LR and DM were constructed using random survival forest (RSF) to deal with total death as a competing risk in the training dataset. Robust models with optimal hyper-parameters were determined using fivefold cross-validation. The patients were dichotomized into two groups based on the median value of the patient-specific risk scores (high-and low-risk score groups). Gray's test was used to evaluate the statistical significance between the two risk score groups. The prognostic power was evaluated by the concordance index with the 95% confidence intervals (CI) via bootstrapping (2000 iterations). Results: The concordance indices at 3 yr of clinical, radiomic, and combined models for LR were 0.57 [

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“…Although current treatment guidelines do not recommend SABR as first-line treatment for Non-Small Cell Lung Cancer (NSCLC) moderate risk patients [ 1 ], multiple observational studies have suggested therapeutic equipoise exists between SABR and surgery in those patients with multiple comorbidities [ 8 , 9 ]. The lack of long term QoL data from these two treatments has highlighted the importance of understanding whether a truly informed, shared treatment decision between patients and clinicians can be made.…”

Section: Introductionmentioning

confidence: 99%

Patients’ confidence in treatment decisions for early stage non-small cell lung cancer (NSCLC)

Pompili

Holch

Rogers

et al. 2020

Health Qual Life Outcomes

View full text Add to dashboard Cite

Background: In early-stage Non-Small Cell Lung Cancer (NSCLC) patients, little is known about how to measure patient participation in Shared-Decision Making (SDM). We examined the psychometric properties and clinical acceptability of the Decision Self-Efficacy scale (DSE) in a cohort of patients undergoing to Stereotactic Ablative Radiotherapy (SABR) or Video-assisted Thoracoscopic Surgery (VATS) to capture patient involvement in treatment decisions. Methods: In the context of a prospective longitudinal study (Life after Lung Cancer-LiLAC) involving 244 patients with early-stage NSCLC, 158 (64.7%) patients completed the DSE either on paper or electronically online prior to treatment with SABR or VATS pulmonary resection. DSE psychometric properties were examined using: principal components analysis of item properties and internal structure, and internal construct validity; we also performed a sensitivity analysis according to Eastern Cooperative Oncology Group Performance Status (ECOG PS), gender, age and treatment received (VATS or SABR) difference. Results: Exploratory factor analysis using polychoric correlations substantiated that the 11 item DSE is one scale accounting for 81% of the variance. We calculated a value of 0.96 for Cronbach's alpha for the total DSE score. DSE scores did not differ by gender (p = 0.37), between the two treatment groups (p = 0.09) and between younger and older patients (p = 0.4). However, patients with an ECOG PS > 1 have a DSE mean of 73.8 (SD 26) compared to patients with a PS 0-1 who have a DSE mean of 85.8 (SD 20.3 p = 0.002). Conclusion: Findings provide preliminary evidence for the reliability and validity of the DSE questionnaire in this population. However, future studies are warranted to identify the most appropriate SDM tool for clinical practice in the lung cancer treatment field.

show abstract

Stereotactic body radiation therapy versus sublobar resection for stage I NSCLC

Cited by 27 publications

References 27 publications

Patients’ confidence in treatment decisions for early stage non-small cell lung cancer (NSCLC)

Patients’ confidence in treatment decisions for early stage non-small cell lung cancer (NSCLC)

Application and limitation of radiomics approach to prognostic prediction for lung stereotactic body radiotherapy using breath‐hold CT images with random survival forest: A multi‐institutional study

Patients’ confidence in treatment decisions for early stage non-small cell lung cancer (NSCLC)

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