Abstract:
Objective To compare the impact of stereotactic body radiation therapy (SBRT) and thoracoscopic sublobar resection on the long-term survival rates of patients with early-stage non-small cell lung cancer (NSCLC).
Methods From March 2019 to February 2024, 62 early-stage non-small cell lung cancer (NSCLC) patients admitted to our hospital were randomly divided into an observation group 30 cases and a control group 32 cases. The observation group received stereotactic body radiation therapy (SBRT), while the control group underwent thoracoscopic sublobar resection. The quality of life before and after treatment was assessed using the Quality of Life Instruments for Cancer Patients-Lung (QLICP-LU), and carcinoembryonic antigen (CEA), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199), carbohydrate antigen 724 (CA724), neuron-specific enolase (NSE), squamous cell carcinoma antigen (SCC), and Alpha-fetoprotein (AFP) were compared, Treatment efficacy was evaluated, overall survival (OS) and progression-free survival (PFS) were recorded.
Results After treatment, the observation group showed higher scores than the control group in the QLICP-LU scale across various domains: physical function (24.07±3.11) vs. ( 22.34±3.03), psychological function (42.97±4.15) vs. (38.78±4.10), social function (21.63±3.45) vs. (23.78±3.51), common symptoms (21.57±4.07) vs. (19.50±3.94), and specific modules (26.37±4.57) vs. (23.84±4.67) (P<0.05). In the observation group, post-treatment levels of CEA (39.48±7.47)ng/ml, CYFRA21-1 (12.46±3.47)ng/ml, CA125 (85.68±4.87)U/ml, CA199 (40.28±4.05)U/ml, and CA724 (6.28±2.00)U/ml were measured. The levels of 64 ng/ml, NSE (20.85±3.87)ng/ml, SCC (2.26±0.72)ng/ml, and AFP (2.84±0.69)U/ml were lower than those in the control group, with CEA (51.52±7.59)ng/ml and CYFRA21-1 (16.83±3.87)ng/ml, CA125 (102.21±5.01) U/ml, CA199 (45.96±3.98)U/ml, CA724 (7.93±2.49)ng/ml, NSE (24.11±3.79)ng/ml, SCC (1.33±0.65)ng/ml, AFP (3. 77±0.63)U/ml (P<0.05). The objective response rate and disease control rate in the observation group were 53.33% and 66.67%, respectively, which were higher than those in the control group (28.13% and 50.00%, respectively)(P<0.05). There was no statistically significant difference in 1-year and 2-year overall survival and progression-free survival between the two groups (P>0.05). The observation group had 14 survivors(46.67%)and 16 deaths(53.33%), while the control group had 7 survivors (21.88%)and 25 deaths(78.12%). The 3-year overall survival of the observation group was 60.00%, significantly higher than the control group′s 3-year overall survival of 34.38% (P=0.043). Similarly, the 3-year progression-free survival of the observation group was 46.64%, significantly higher than the control group′s 3-year overall survival of 21.88%(P=0.039).
Conclusion Stereotactic radiotherapy is superior to thoracoscopic sublobectomy in improving clinical efficacy, 3-year overall survival, progression-free survival and quality of life in early-stage NSCLC patients, and can be used as an alternative treatment for some patients, especially those at high surgical risk.
Key words:
Early-stage non-small cell lung cancer,
Stereotactic body radiation therapy,
Thoracoscopic sublobar resection,
Progression-free survival,
Quality of life
Hanqing Xie, Li Zhao, Botao Hu, Bingcheng Chen, Guojiu Zhong, Jian Huang. Influence of stereotactic body radiation therapy and thoracoscopic sublobectomy on the long-term survival rate of patients with early-stage non-small cell lung cancer[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(06): 885-890.