What Is the Best Approach for High-Risk or Inoperable NSCLC? - OncologySTAT

What Is the Best Approach for High-Risk or Inoperable NSCLC? - OncologySTAT

More recently, stereotactic body radiation therapy (SBRT) and radiofrequency ablation (RFA) have been offered as alternatives for medically inoperable and even for high-risk surgical patients, based on early, encouraging results.

Dr. Arjun Pennathur of the University of Pittsburgh and his colleagues are among a growing group of researchers who are demonstrating the benefits of RFA and SBRT as either a curative approach for early-stage non-small cell lung cancer (NSCLC) or as a palliative approach to more advanced lung neoplasms. Dr. Pennathur's group reported
SBRT survival rates at 1 and 5 years of 81% and 60%, respectively. Other researchers reported SBRT 1-year survival rates of 90%-95%, with 2-year survival of 60%-75%, and 5-year survival of 20%-65%.

For RFA treatment, Dr. Pennathur reported 1-year survival of stage I NSCLC patients at 95% and 2-year survival at 68%, as noted in an article by Dr. Hiran C. Fernando and colleagues from Boston University (Ann. Thorac. Surg. 2010;89:S2123-7).

Dr. Huang of the Fourth Military Medical University in Xi'an, China, found that progression-free survival was directly related to tumor size. Local progression occurred in 27% of patients with tumors measuring less than 3 cm and in 27.5% of patients with tumors of 3-4 cm, a nonsignificant difference. However, 42% of patients with tumors larger than 4 cm had a local recurrence, which was a significant difference. Based upon their findings, they recommended that RFA not be used in patients with tumors larger than 4 cm.