Use and Outcomes of SBRT for Early Stage NSCLC Without Pathologic Confirmation in the Veterans Health Care Administration

• DOI: 10.1016/j.adro.2021.100707
• Publication Date: 2021-04-20T23:20:49Z
• Authors: Joel R. Wilkie; Rachel Lipson; Matthew C. Johnson; Christina Williams; Drew Moghanaki; David Elliott; Dawn Owen; Namratha Atluri; Shruti Jolly; Christina Hunter ...
• Keywords: Veterans Affairs

Stereotactic body radiation therapy (SBRT) use has increased among patients without pathologic confirmation (PC) of lung cancer. Empirical SBRT PC raises concerns about variation in workup and patient selection, but national trends have not been well described. In this study, we assessed patterns empirical use, workup, causes death a large non-small cell cancer (NSCLC) cohort.We identified 2221 treated with for cT1-T2aN0M0 NSCLC the Veterans Affairs health care system from 2008 to 2015. We reviewed their pretreatment associations between absence clinical demographic factors. compared non-PC groups used Cox proportional hazards modeling compare overall survival specific (LCSS) these groups.Treatment varied 0% 61% medical centers, at least 5 cases stage I NSCLC. Overall, 14.9% were 8.8% did biopsy attempt. Ten percent facilities responsible almost two-thirds (62%) treatment PC. Of patients, 95.5% had positron emission tomography scans, 40.6% procedures attempted, 12.7% underwent endobronchial ultrasound. Non-PC more likely cT1 tumors live outside histoplasmosis belt. Age, sex, smoking status, Charlson comorbidity index similar groups. Lung was most common cause both Overall groups, whereas better LCSS (hazard ratio = 0.77, P .031).Empirical widely institutions appropriate radiographic consistently cohort. Future studies should investigate determinants reasons higher patients.