Purpose

To retrospectively compare the outcomes of radiofrequency (RF) ablation, stereotactic body radiotherapy (SBRT), and sublobar resection (SLR) in patients with stage I non–small-cell lung cancer (NSCLC) at a single center.

Materials and Methods

Overall, 289 patients (38 RF ablation, 58 SBRT, and 193 SLR) were included. Kaplan-Meier curves were generated, multiple propensity score was estimated using a multinomial logistic regression model, and relationships between treatments and outcomes were assessed using a Cox proportional hazard model. Hazard ratios (HRs) for death from any cause and disease progression or death from any cause were examined by a crude model, an inverse probability of treatment weighting (IPTW) model, and an IPTW model adjusted for missing variables.

Results

The 5-year overall and progression-free survival rates were 58.9% and 39.9%, respectively, for RF ablation; 42.0% and 34.9%, respectively, for SBRT; and 85.5% and 75.9%, respectively, for SLR. Significantly longer survival time and lower HR were observed for SLR than other treatments. However, after statistical adjustment, these relationships were not significant except for reduced HR of disease progression or death from any cause of SLR compared to RF ablation in the IPTW model. The median hospital stays for RF ablation, SBRT, and SLR were 6.5, 6, and 16 days, respectively. Adverse events of grade 3 or higher occurred only in 11 SLR cases.

Conclusions

SLR achieved the longest survival. However, after statistical adjustment, there were no significant outcome differences among RF ablation, SBRT, and SLR, except for 1 model. RF ablation or SBRT may be alternative treatments for selected patients with early-stage NSCLC.

中文翻译：

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临床I期非小细胞肺癌患者的射频消融，立体定向放射治疗或大叶下切除治疗的生存结果：单中心评估。

目的

回顾性比较单个中心I期非小细胞肺癌（NSCLC）患者的射频消融，立体定向放射疗法（SBRT）和肺叶下切除（SLR）的结果。

材料和方法

总共包括289例患者（38例射频消融，58例SBRT和193例SLR）。产生Kaplan-Meier曲线，使用多项式Lo​​gistic回归模型评估多个倾向评分，并使用Cox比例风险模型评估治疗与结果之间的关系。由粗略模型，治疗加权比的倒数概率（IPTW）模型和针对缺失变量进行调整的IPTW模型检查了因任何原因死亡和疾病进展或因任何原因死亡的危险比（HRs）。

结果

射频消融的5年总生存率和无进展生存率分别为58.9％和39.9％。SBRT分别为42.0％和34.9％；单反相机分别为85.5％和75.9％。与其他治疗相比，单反显着延长了生存时间，降低了心率。但是，经过统计学调整后，除了IPTW模型中的RF消融外，这些关系除疾病进展或因任何SLR引起的死亡的HR降低外，其他关系均不显着。射频消融，SBRT和SLR的中位住院时间分别为6.5天，6天和16天。仅在11例SLR病例中发生了3级或更高级别的不良事件。

结论

单反相机的生存时间最长。但是，经过统计学调整后，除1个模型外，RF消融，SBRT和SLR之间没有显着的结局差异。对于某些早期NSCLC患者，射频消融或SBRT可能是替代疗法。