Thermal Ablation and Stereotactic Radiation Produce Similar Survival Rates in Early Stage Lung Cancer Patients

A recent study found no difference in mortality rates among stage 1 non-small cell lung cancer (NSCLC) patients whether they were treated with thermal ablation (TA) or stereotactic radiation therapy (SRT). 

Using the 2004-2013 National Cancer Database, researchers pulled data on 28,834 patients (TA, 1,102 patients; SRT, 27,732 patients). TA patients had more comorbidities (Charlson comorbidity index of 1 vs ≥ 2, 32.8% [362 of 1,102] vs 19.7% [217 of 1,102], respectively) than SRT patients (Charlson comorbidity index of 1 vs ≥ 2, 26.9% [7,448 of 27,732] vs 15.3% [4,251 of 27,732], respectively; P = .001) and smaller tumor size (mean tumor size, TA vs SRT: 19 mm vs 22 mm, respectively; P = .001) 

When distributing evenly for potential confounding factors, at a mean follow-up of 52.4 years, survival rates were not statistically different between TA and SRT patients (survival difference, P = 0.69). Survival rates between the TA and SRT groups did not largely differ at one year 85.4% vs 86.3%, respectively; P = 0.76) two years (65.2% vs 64.5%, respectively; P = 0.43), three years (47.8% vs 45.9%, respectively; P = 0.32), and five years (24.6% vs 26.1%, respectively; P = 0.81). 

TA patients had higher unplanned hospital readmission rates than the SRT cohort (3.7% [40 of 1,070] vs 0.2% [two of 1,070], respectively; P = 0.001). 

Another benefit of TA is that it is a one-time treatment, noted senior study author Hyun S. Kim, MD, of the Yale Cancer Center and Yale School of Medicine. 

“Thermal ablation is most often a one-time treatment, unlike SRT, which requires multiple visits,” Kim said. “In addition, ablation delivers highly accurate and precise localized treatment only to cancer cells, minimizing the effects to surrounding tissue and keeping the toxicity low.” 

TA also gives direct access to the tumor. 

“This is a real value to our patients, especially as tissue sampling becomes more and more important in personalized, precision cancer treatments,” Kim said. 

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SourcesRadiology, RSNA