A competing risk analysis of the patterns and risk factors of recurrence in early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy

• Published in: Radiotherapy and oncology 2023-08, Vol.185, p.109697-109697, Article 109697
• Main Authors: Tonneau, Marion, Richard, Corentin, Routy, Bertrand, Campeau, Marie-Pierre, Vu, Toni, Filion, Edith, Roberge, David, Mathieu, Dominique, Doucet, Robert, Beliveau-Nadeau, Dominic, Bahig, Houda
• Format: Article
• Language: English
• Subjects: Carcinoma, Non-Small-Cell Lung - pathology; Competing risk analysis; Early-stage non-small cell lung cancer; Humans; Lung Neoplasms - pathology; Neoplasm Staging; Radiosurgery; Retrospective Studies; Risk Assessment; Risk Factors; SABR; Small Cell Lung Carcinoma - pathology; Stereotactic ablative radiation therapy; Treatment Outcome
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2023.109697

•The main prognostic factor for LR and RR risks was central location.•After a first recurrence, OS was similar for ultra-central, central, and peripheral lesions.•After a first recurrence, patients with contralateral lung recurrence and those who were eligible to receive a second course of SABR had improved OS. To assess patterns of recurrence after stereotactic ablative radiotherapy (SABR) in patient ineligible to surgery with early-stage non-small cell lung cancer (ES-NSCLC), report survival and treatment after first recurrence. We performed a retrospective analysis on 1068 patients with ES-NSCLC and 1143 lesions. Between group differences were estimated using competing risk analysis and cause-specific hazard ratios were calculated. Overall survival (OS) after first recurrence was calculated. Median follow-up was 37.6 months. Univariate analysis demonstrated that ultra-central location was associated with higher risk of regional recurrence (RR) and distant metastasis (DM) (p = 0.004 and 0.01). Central lesions were associated with higher risk of local recurrence (LR) and RR (p