Quality of Life of Stereotactic Versus Hypofractionated Radiation Therapy for Inoperable Stage I Non-Small Cell Lung Cancer: Results From the LUSTRE Trial
Abstract
Purpose: There is limited evidence on quality-of-life (QoL) outcomes of stereotactic body radiation therapy (SBRT) compared with conventionally hypofractionated radiation therapy (CHRT) in patients with medically inoperable stage I (≤5 cm) non-small cell lung cancer (NSCLC).
Methods and materials: This phase 3 randomized trial was conducted across 16 Canadian centers, enrolling patients with medically inoperable stage I (≤5 cm) NSCLC. Participants were randomized in a 2:1 ratio to receive SBRT or CHRT. QoL was assessed over 2 years postrandomization using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the lung cancer-specific module 13 (LC-13), evaluating physical, symptom, functional, and social well-being. Differences in QoL between treatment groups at 2 weeks and 2 years were analyzed using linear mixed models, adjusting for baseline scores and stratification variables.
Results: Of the 233 patients, 154 received SBRT and 79 received CHRT. At 2 weeks, model estimated mean global health scores were higher in the SBRT group (68.93 vs 64.93), with an estimated mean difference of 4.00 (95% CI 3.12, 4.89, P < .01). At 24 months, global health scores were 59.96 for SBRT and 62.88 for CHRT, with a difference of -2.92, 95% CI: -3.73, -2.11, P < .01). Mean LC-13 symptom scores at 2 weeks were 15.70 for SBRT and 17.11 for CHRT, with a difference of -1.41 (95% CI: -1.87, -0.95, P < .01). Mean difference in LC-13 at 24 months…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 233 participants or records.
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