Can Salvage Treatment Improve Survival in Early-Stage Lung Cancer?
Posted: Tuesday, October 23, 2018
Patients with non–small cell lung cancer (NSCLC) who received salvage therapy after local recurrence showed similar survival outcomes as patients with no recurrence, according to data from a study published in JAMA Network Open. To better understand outcomes when disease recurs after stereotactic ablative radiotherapy, Eric D. Brooks, MD, of The University of Texas, and colleagues, studied how salvage therapy has differing impacts for local and isolated regional recurrence.
“Although salvage treatment offers better outcomes as a whole, [isolated local recurrence and isolated regional recurrence] represent two distinct clinical paths, an important distinction for clinicians managing such cases,” the researchers commented.
A total of 912 patients who received stereotactic ablative radiotherapy for early-stage I to II NSCLC were prospectively enrolled in a database at a tertiary cancer center from January 2004 through December 2014. Patients with recurrence underwent salvage therapy, including stereotactic ablative radiotherapy, surgery, thermal ablation, chemotherapy, chemoradiotherapy, and conventional radiotherapy, whereas 10 patients had no treatment.
Patients with isolated local recurrence or isolated regional recurrence who received salvage treatment (n = 87) showed significantly improved overall survival compared with patients with isolated local recurrence or isolated regional recurrence who did not receive salvage treatment (n = 15). For patients with isolated local recurrence after stereotactic ablative radiotherapy who then received salvage treatment, their life expectancy was no different from that of patients without recurrence. “At 3 years after recurrence, 50% to 60% of patients with isolated local recurrence or isolated regional recurrence who received salvage treatment never had another recurrence, showing that the potential cure rate with salvage treatment for such patients can be substantial,” researchers concluded.