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Routine CT scans after SBRT effectively detect NSCLC progression
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Routine CT scans within the first 2 years after stereotactic body radiotherapy effectively detected early disease progression in patients with early-stage non–small cell lung cancer, according to study results.
The risk for second primary lung cancer remains elevated in this patient population, particularly among current and former smokers, results showed.
Patients with early-stage NSCLC who undergo stereotactic body radiation therapy (SBRT) can develop locoregional and distant recurrence, and they also are at risk for second primary lung cancers. However, the ideal surveillance regimen for this patient population has not been established.
In the current study, Daniel E. Spratt, MD, of the department of radiation oncology at Memorial Sloan Kettering Cancer Center in New York, and colleagues assessed post-treatment recurrence patterns and development of second primary lung cancers in this patient population.
They evaluated 336 patients who underwent (SBRT) for early-stage NSCLC between 2006 and 2013.
All study participants underwent CT scans of the chest every 3 months during the first 2 years; once every 6 months during years 3 and 4; and annually thereafter.
Researchers used competing-risks analysis for time-to-event analyses.
Median follow-up was 23 months.
Results revealed 2-year cumulative incidence of 12.2% for local failure, 16.1% for nodal failure and 15.5% for distant failure.
Researchers determined 108 patients had recurrences after SBRT, 91 (84%) of whom showed disease progression within the first 2 years.
Nineteen (5%) patients developed a second primary lung cancer. Median time to development of second primary lung cancer was 16.5 months (range, 6.5-71.1). Six patients (33%) developed second primary lung cancers after 2 years.
No never-smokers developed second primary lung cancers, whereas 15% of current tobacco smokers and 4% of former tobacco smokers developed second primary lung cancer (P = .005). – by Jeff Craven
Disclosure: The researchers report paid consultant roles with Bristol Myers Squibb, as well as grants from Boehringer Ingelheim and Varian Medical Systems.
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