PMID- 35816617 OWN - NLM STAT- MEDLINE DCOM- 20221205 LR - 20231202 IS - 2325-6621 (Electronic) IS - 2329-6933 (Print) IS - 2325-6621 (Linking) VI - 19 IP - 12 DP - 2022 Dec TI - Adverse Events Following Limited Resection versus Stereotactic Body Radiation Therapy for Early Stage Lung Cancer. PG - 2053-2061 LID - 10.1513/AnnalsATS.202203-275OC [doi] AB - Rationale: Approximately a quarter of patients with early stage lung cancer are not medically fit for lobectomy. Limited resection and stereotactic body radiation therapy (SBRT) have emerged as alternatives for these patients. Given the equipoise on the effectiveness of the two treatments, treatment-related adverse events (AEs) could have a significant impact on patients' decision-making and treatment outcomes. Objectives: To compare the AE profile between SBRT versus limited resection. Methods: Data were derived from a prospective cohort of patients with stage I-IIA non-small cell lung cancer who were deemed as high-risk for lobectomy recruited from five centers across the United States. Propensity scores and inverse probability weighting were used to compare the rates of 30- and 90-day AEs among patients treated with limited resection versus SBRT. Results: Overall, 65% of 252 patients underwent SBRT. After adjusting for propensity scores, there was no significant difference in developing at least one AE comparing SBRT to limited resection (odds ratio [OR]: 1.00; 95% confidence interval [CI]: 0.65-1.55 and OR: 1.27; 95% CI: 0.84-1.91 at 30 and 90 days, respectively). SBRT was associated with lower risk of infectious AEs than limited resection at 30 days (OR: 0.05; 95% CI: 0.01-0.39) and 90 days posttreatment (OR: 0.41; 95% CI: 0.17-0.98). Additionally, SBRT was associated with persistently elevated risk of fatigue (OR: 2.47; 95% CI: 1.34-4.54 at 30 days and OR: 2.69; 95% CI: 1.52-4.77 at 90 days, respectively), but significantly lower risks of respiratory AEs (OR: 0.36; 95% CI: 0.20-0.65 and OR: 0.51; 95% CI: 0.31-0.86 at 30 and 90 days, respectively). Conclusions: Though equivalent in developing at least one AE, we found that SBRT is associated with less toxicity than limited resection in terms of infectious and respiratory AEs but higher rates of fatigue that persisted up to 3 months posttreatment. This information, combined with data about oncologic effectiveness, can help patients' decision-making regarding these alternative therapies. FAU - Wang, Qian AU - Wang Q AUID- ORCID: 0000-0002-1201-865X AD - Tisch Cancer Institute. FAU - Stone, Kimberly AU - Stone K AD - Division of General Internal Medicine, and. FAU - Kern, Jeffrey A AU - Kern JA AD - Division of Oncology, National Jewish Health, Denver, Colorado. FAU - Slatore, Christopher G AU - Slatore CG AD - Center to Improve Veteran Involvement in Care and. AD - Section of Pulmonary and Critical Care Medicine, VA Portland Health Care System, Portland, Oregon. AD - Division of Pulmonary and Critical Care Medicine, Department of Medicine, and. AD - Department of Radiation Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon. FAU - Swanson, Scott AU - Swanson S AD - Department of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts. FAU - Blackstock, William Jr AU - Blackstock W Jr AD - Department of Radiology, Wake Forest Baptist Medical Center, Winston Salem, North Carolina; and. FAU - Khan, Rabia Saeed AU - Khan RS AD - Division of General Internal Medicine, and. FAU - Smith, Cardinale B AU - Smith CB AD - Tisch Cancer Institute. FAU - Veluswamy, Rajwanth R AU - Veluswamy RR AD - Tisch Cancer Institute. FAU - Chidel, Mark AU - Chidel M AD - Department of Radiation Oncology, Colorado Permanente Medical Group, Denver, Colorado. FAU - Wisnivesky, Juan P AU - Wisnivesky JP AD - Division of General Internal Medicine, and. AD - Division of Pulmonary and Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. LA - eng GR - R01 CA203193/CA/NCI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, Non-P.H.S. PL - United States TA - Ann Am Thorac Soc JT - Annals of the American Thoracic Society JID - 101600811 SB - IM CIN - Ann Am Thorac Soc. 2022 Dec;19(12):1975-1976. PMID: 36454168 MH - Humans MH - United States MH - *Radiosurgery/adverse effects MH - *Carcinoma, Non-Small-Cell Lung/radiotherapy/surgery/pathology MH - *Lung Neoplasms/radiotherapy/surgery/pathology MH - Prospective Studies MH - Neoplasm Staging MH - Treatment Outcome MH - Fatigue PMC - PMC9743482 OTO - NOTNLM OT - adverse events OT - early stage lung cancer OT - limited resection OT - non-small cell lung cancer OT - stereotactic body radiation therapy EDAT- 2022/07/12 06:00 MHDA- 2022/12/06 06:00 PMCR- 2023/12/01 CRDT- 2022/07/11 14:32 PHST- 2022/07/12 06:00 [pubmed] PHST- 2022/12/06 06:00 [medline] PHST- 2022/07/11 14:32 [entrez] PHST- 2023/12/01 00:00 [pmc-release] AID - 10.1513/AnnalsATS.202203-275OC [doi] PST - ppublish SO - Ann Am Thorac Soc. 2022 Dec;19(12):2053-2061. doi: 10.1513/AnnalsATS.202203-275OC.