Stereotactic Ablative Radiotherapy for Early-Stage NSCLC With Interstitial Lung Disease

By: Joshua D. Madera, MD
Posted: Monday, May 20, 2024

The need for efficacious management strategies for patients with fibrotic interstitial lung disease and non–small cell lung cancer (NSCLC) has prompted researchers to investigate the clinical outcomes associated with stereotactic ablative radiotherapy (SABR), according to a study published in JAMA Oncology. The results of this phase II nonrandomized clinical trial demonstrated an acceptable efficacy and toxicity threshold in this patient population, suggesting its clinical use as a therapeutic alternative, explained Christopher J. Ryerson, MD, of the University of British Columbia, Vancouver, and colleagues.

“Further studies exploring pharmacologic options to reduce radiotherapy-induced toxic effects may be beneficial in this population,” suggested the study authors. However, “a careful discussion of risks and benefits” is warranted.

From 2019 to 2022, a total of 39 patients with early-stage NSCLC were recruited for the study. All participants were deemed ineligible for treatment with surgical resection. Physical examination and pulmonary function testing were performed on all patients at baseline. Patients were then administered SABR every other day and monitored closely to assess their clinical outcomes.

At the 1-year interval, the study findings revealed an overall survival rate of 79%. In addition, the median overall survival and progression-free survival were 25 months and 19 months, respectively. Local tumor control at the 2-year interval was 92%.

Furthermore, patients experienced treatment-related adverse events that included grade 1 or 2 (30.8%), grade 3 (10.3%), and grade 5 (7.7%) events. According to the investigators, all the grade 5 treatment-related adverse events were attributed to respiratory deterioration. Moreover, patient-reported quality of life showed a significant reduction in functional and social well-being subdomains, and cough severity scale scores worsened over time.

Disclosure: For full disclosures of the study authors, visit jamanetwork.com.

JAMA Oncology

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