International journal of radiation oncology, biology, physics · 2025
Quality of Life of Stereotactic Versus Hypofractionated Radiation Therapy for Inoperable Stage I Non-Small Cell Lung Cancer: Results From the LUSTRE Trial.
СтатьяРандомизированное исследованиеКлиническое исследование III фазыМногоцентровое исследованиеСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Hou Qirui, Parpia Sameer, Wierzbicki Marcin, Kundapur Vijayananda, Faria Sergio, Okawara Gordon S, Tsakiridis Theodoros K, Ahmed Naseer, Bujold Alexis, Hirmiz Khalid, Owen Timothy, Leong Nelson, Ramchandar Kevin, Filion Edith, Lau Harold, Gabos Zsolt, Thompson Robert, Yaremko Brian, Mehiri Selma, Louie Alexander V, Quan Kimmen, Levine Mark N, Wright James R, Whelan Timothy J, Swaminath Anand
Аннотация
PURPOSE: There is limited evidence on quality-of-life (QoL) outcomes of stereotactic body radiation therapy (SBRT) compared with conventionally hypofractionated radiation therapy (CHRT) in patients with medically inoperable stage I (≤5 cm) non-small cell lung cancer (NSCLC).
METHODS AND MATERIALS: This phase 3 randomized trial was conducted across 16 Canadian centers, enrolling patients with medically inoperable stage I (≤5 cm) NSCLC. Participants were randomized in a 2:1 ratio to receive SBRT or CHRT. QoL was assessed over 2 years postrandomization using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the lung cancer-specific module 13 (LC-13), evaluating physical, symptom, functional, and social well-being. Differences in QoL between treatment groups at 2 weeks and 2 years were analyzed using linear mixed models, adjusting for baseline scores and stratification variables.
RESULTS: Of the 233 patients, 154 received SBRT and 79 received CHRT. At 2 weeks, model estimated mean global health scores were higher in the SBRT group (68.93 vs 64.93), with an estimated mean difference of 4.00 (95% CI 3.12, 4.89, P < .01). At 24 months, global health scores were 59.96 for SBRT and 62.88 for CHRT, with a difference of -2.92, 95% CI: -3.73, -2.11, P < .01). Mean LC-13 symptom scores at 2 weeks were 15.70 for SBRT and 17.11 for CHRT, with a difference of -1.41 (95% CI: -1.87, -0.95, P < .01). Mean difference in LC-13 at 24 months was 0.14 (95% CI: -0.29, 0.57, P = .69).
CONCLUSIONS: SBRT offers modest benefit in acute QoL and similar benefit in long-term QoL compared with CHRT in patients with inoperable stage I NSCLC.
METHODS AND MATERIALS: This phase 3 randomized trial was conducted across 16 Canadian centers, enrolling patients with medically inoperable stage I (≤5 cm) NSCLC. Participants were randomized in a 2:1 ratio to receive SBRT or CHRT. QoL was assessed over 2 years postrandomization using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the lung cancer-specific module 13 (LC-13), evaluating physical, symptom, functional, and social well-being. Differences in QoL between treatment groups at 2 weeks and 2 years were analyzed using linear mixed models, adjusting for baseline scores and stratification variables.
RESULTS: Of the 233 patients, 154 received SBRT and 79 received CHRT. At 2 weeks, model estimated mean global health scores were higher in the SBRT group (68.93 vs 64.93), with an estimated mean difference of 4.00 (95% CI 3.12, 4.89, P < .01). At 24 months, global health scores were 59.96 for SBRT and 62.88 for CHRT, with a difference of -2.92, 95% CI: -3.73, -2.11, P < .01). Mean LC-13 symptom scores at 2 weeks were 15.70 for SBRT and 17.11 for CHRT, with a difference of -1.41 (95% CI: -1.87, -0.95, P < .01). Mean difference in LC-13 at 24 months was 0.14 (95% CI: -0.29, 0.57, P = .69).
CONCLUSIONS: SBRT offers modest benefit in acute QoL and similar benefit in long-term QoL compared with CHRT in patients with inoperable stage I NSCLC.