Stereotactic body radiotherapy versus lobectomy for operable clinical stage IA lung adenocarcinoma: Comparison of survival outcomes in two clinical trials with propensity score analysis (JCOG1313-A)

on behalf of the Lung Cancer Surgical Study Group and the Radiation Therapy Study Group of the Japan Clinical Oncology Group

Research output: Contribution to journalArticle

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Abstract

Objective: No randomized controlled trials comparing stereotactic body radiotherapy and lobectomy for operable early-stage non-small-cell lung cancer have been successfully conducted. This study compared survival outcomes in two multi-institutional clinical trials for stereotactic body radiotherapy (Japan Clinical Oncology Group JCOG0403) and lobectomy (Japan Clinical Oncology Group JCOG0201) with propensity score analysis.Methods: Inclusion criteria were operable, cT1N0M0 and adenocarcinoma diagnosed prior to registration of each trial. Forty of 169 patients from JCOG0403 and 219 of 811 patients from JCOG0201 were included. The primary endpoint was overall survival adjusted with propensity score analysis. The patient selection factors included in the logistic model to estimate the propensity score were age, sex, tumor diameter and consolidation/tumor ratio.Results: Among patient selection factors, age distribution was quite different with little overlap: the median was 79 (interquartile range: 74.5-83.5) in stereotactic body radiotherapy and 62 (interquartile range: 55-68) in lobectomy. In propensity score analysis, 21 patients from each group were matched and the hazard ratio for stereotactic body radiotherapy over lobectomy was 9.00 (95% confidence interval: 1.14-71.04). In the post hoc subgroup analysis with propensity score analysis of inverse probability of treatment weighting, patients were limited to be aged 75 or younger because JCOG0201 only included them when aged 75 or younger. Thirteen patients for stereotactic body radiotherapy and 219 for lobectomy were compared, and the hazard ratio for stereotactic body radiotherapy over lobectomy was 1.19 (95% confidence interval: 0.38-3.73).Conclusions: The point estimates of hazard ratio favored lobectomy over stereotactic body radiotherapy in the limited number of patients. A randomized controlled study is needed for valid comparison.

Original languageEnglish
Article numberhyw058
Pages (from-to)748-753
Number of pages6
JournalJapanese Journal of Clinical Oncology
Volume46
Issue number8
DOIs
Publication statusPublished - 2016 Aug 1

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Propensity Score
Radiosurgery
Clinical Trials
Survival
Medical Oncology
Patient Selection
Japan
Confidence Intervals
Age Distribution
Adenocarcinoma of lung
Non-Small Cell Lung Carcinoma
Neoplasms
Adenocarcinoma
Research Design
Randomized Controlled Trials
Logistic Models

Keywords

  • Lobectomy
  • Lung cancer
  • Operable
  • Propensity score analysis
  • Stereotactic body radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Stereotactic body radiotherapy versus lobectomy for operable clinical stage IA lung adenocarcinoma : Comparison of survival outcomes in two clinical trials with propensity score analysis (JCOG1313-A). / on behalf of the Lung Cancer Surgical Study Group and the Radiation Therapy Study Group of the Japan Clinical Oncology Group.

In: Japanese Journal of Clinical Oncology, Vol. 46, No. 8, hyw058, 01.08.2016, p. 748-753.

Research output: Contribution to journalArticle

on behalf of the Lung Cancer Surgical Study Group and the Radiation Therapy Study Group of the Japan Clinical Oncology Group. / Stereotactic body radiotherapy versus lobectomy for operable clinical stage IA lung adenocarcinoma : Comparison of survival outcomes in two clinical trials with propensity score analysis (JCOG1313-A). In: Japanese Journal of Clinical Oncology. 2016 ; Vol. 46, No. 8. pp. 748-753.
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abstract = "Objective: No randomized controlled trials comparing stereotactic body radiotherapy and lobectomy for operable early-stage non-small-cell lung cancer have been successfully conducted. This study compared survival outcomes in two multi-institutional clinical trials for stereotactic body radiotherapy (Japan Clinical Oncology Group JCOG0403) and lobectomy (Japan Clinical Oncology Group JCOG0201) with propensity score analysis.Methods: Inclusion criteria were operable, cT1N0M0 and adenocarcinoma diagnosed prior to registration of each trial. Forty of 169 patients from JCOG0403 and 219 of 811 patients from JCOG0201 were included. The primary endpoint was overall survival adjusted with propensity score analysis. The patient selection factors included in the logistic model to estimate the propensity score were age, sex, tumor diameter and consolidation/tumor ratio.Results: Among patient selection factors, age distribution was quite different with little overlap: the median was 79 (interquartile range: 74.5-83.5) in stereotactic body radiotherapy and 62 (interquartile range: 55-68) in lobectomy. In propensity score analysis, 21 patients from each group were matched and the hazard ratio for stereotactic body radiotherapy over lobectomy was 9.00 (95{\%} confidence interval: 1.14-71.04). In the post hoc subgroup analysis with propensity score analysis of inverse probability of treatment weighting, patients were limited to be aged 75 or younger because JCOG0201 only included them when aged 75 or younger. Thirteen patients for stereotactic body radiotherapy and 219 for lobectomy were compared, and the hazard ratio for stereotactic body radiotherapy over lobectomy was 1.19 (95{\%} confidence interval: 0.38-3.73).Conclusions: The point estimates of hazard ratio favored lobectomy over stereotactic body radiotherapy in the limited number of patients. A randomized controlled study is needed for valid comparison.",
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author = "{on behalf of the Lung Cancer Surgical Study Group and the Radiation Therapy Study Group of the Japan Clinical Oncology Group} and Junko Eba and Kenichi Nakamura and Junki Mizusawa and Kenji Suzuki and Yasushi Nagata and Teruaki Koike and Masahiro Hiraoka and Watanabe, {Shun ichi} and Satoshi Ishikura and Hisao Asamura and Haruhikoon Fukuda",
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T1 - Stereotactic body radiotherapy versus lobectomy for operable clinical stage IA lung adenocarcinoma

T2 - Comparison of survival outcomes in two clinical trials with propensity score analysis (JCOG1313-A)

AU - on behalf of the Lung Cancer Surgical Study Group and the Radiation Therapy Study Group of the Japan Clinical Oncology Group

AU - Eba, Junko

AU - Nakamura, Kenichi

AU - Mizusawa, Junki

AU - Suzuki, Kenji

AU - Nagata, Yasushi

AU - Koike, Teruaki

AU - Hiraoka, Masahiro

AU - Watanabe, Shun ichi

AU - Ishikura, Satoshi

AU - Asamura, Hisao

AU - Fukuda, Haruhikoon

PY - 2016/8/1

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N2 - Objective: No randomized controlled trials comparing stereotactic body radiotherapy and lobectomy for operable early-stage non-small-cell lung cancer have been successfully conducted. This study compared survival outcomes in two multi-institutional clinical trials for stereotactic body radiotherapy (Japan Clinical Oncology Group JCOG0403) and lobectomy (Japan Clinical Oncology Group JCOG0201) with propensity score analysis.Methods: Inclusion criteria were operable, cT1N0M0 and adenocarcinoma diagnosed prior to registration of each trial. Forty of 169 patients from JCOG0403 and 219 of 811 patients from JCOG0201 were included. The primary endpoint was overall survival adjusted with propensity score analysis. The patient selection factors included in the logistic model to estimate the propensity score were age, sex, tumor diameter and consolidation/tumor ratio.Results: Among patient selection factors, age distribution was quite different with little overlap: the median was 79 (interquartile range: 74.5-83.5) in stereotactic body radiotherapy and 62 (interquartile range: 55-68) in lobectomy. In propensity score analysis, 21 patients from each group were matched and the hazard ratio for stereotactic body radiotherapy over lobectomy was 9.00 (95% confidence interval: 1.14-71.04). In the post hoc subgroup analysis with propensity score analysis of inverse probability of treatment weighting, patients were limited to be aged 75 or younger because JCOG0201 only included them when aged 75 or younger. Thirteen patients for stereotactic body radiotherapy and 219 for lobectomy were compared, and the hazard ratio for stereotactic body radiotherapy over lobectomy was 1.19 (95% confidence interval: 0.38-3.73).Conclusions: The point estimates of hazard ratio favored lobectomy over stereotactic body radiotherapy in the limited number of patients. A randomized controlled study is needed for valid comparison.

AB - Objective: No randomized controlled trials comparing stereotactic body radiotherapy and lobectomy for operable early-stage non-small-cell lung cancer have been successfully conducted. This study compared survival outcomes in two multi-institutional clinical trials for stereotactic body radiotherapy (Japan Clinical Oncology Group JCOG0403) and lobectomy (Japan Clinical Oncology Group JCOG0201) with propensity score analysis.Methods: Inclusion criteria were operable, cT1N0M0 and adenocarcinoma diagnosed prior to registration of each trial. Forty of 169 patients from JCOG0403 and 219 of 811 patients from JCOG0201 were included. The primary endpoint was overall survival adjusted with propensity score analysis. The patient selection factors included in the logistic model to estimate the propensity score were age, sex, tumor diameter and consolidation/tumor ratio.Results: Among patient selection factors, age distribution was quite different with little overlap: the median was 79 (interquartile range: 74.5-83.5) in stereotactic body radiotherapy and 62 (interquartile range: 55-68) in lobectomy. In propensity score analysis, 21 patients from each group were matched and the hazard ratio for stereotactic body radiotherapy over lobectomy was 9.00 (95% confidence interval: 1.14-71.04). In the post hoc subgroup analysis with propensity score analysis of inverse probability of treatment weighting, patients were limited to be aged 75 or younger because JCOG0201 only included them when aged 75 or younger. Thirteen patients for stereotactic body radiotherapy and 219 for lobectomy were compared, and the hazard ratio for stereotactic body radiotherapy over lobectomy was 1.19 (95% confidence interval: 0.38-3.73).Conclusions: The point estimates of hazard ratio favored lobectomy over stereotactic body radiotherapy in the limited number of patients. A randomized controlled study is needed for valid comparison.

KW - Lobectomy

KW - Lung cancer

KW - Operable

KW - Propensity score analysis

KW - Stereotactic body radiotherapy

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