Comparison of Survival Outcomes of Early-Stage Non-Small-Cell Lung Cancer in Elderly Patients (≥ 70 years) Treated With Stereotactic Body Radiotherapy Versus Surgical Resection.

Abstract

To evaluate the survival outcomes of stereotactic body radiotherapy (SBRT) versus surgical resection in elderly patients (≥ 70 years old) with early-stage non-small-cell lung cancer (NSCLC). A systematic search was conducted across databases such as PubMed, Web of Science, EMBASE, Cochrane Library, CNKI, VIP, and Wanfang to collect comparative studies on the survival outcomes of SBRT versus surgery for early-stage NSCLC in elderly patients, with searches up to December 2023 and statistical analysis performed using Stata software. This meta-analysis included 10 comparative studies, encompassing 9410 elderly patients with early-stage NSCLC. The results indicated that the SBRT group had worse outcomes compared to the surgery group in terms of 3-year overall survival (OS) [HR = 1.31, 95% CI (1.02-1.70), p < 0.05], 5-year OS [HR = 1.37, 95% CI (1.06-1.77), p < 0.05], 1-year cancer-specific survival (CSS) [HR = 1.32, 95% CI (1.03-1.68), p < 0.05], 3-year CSS [HR = 1.89, 95% CI (1.70-2.11), p < 0.01], and 5-year CSS [HR = 1.92, 95% CI (1.75-2.10), p < 0.01]. There were no statistically significant differences between the two groups in terms of 1-year OS, 1-year, 3-year, and 5-year progression-free survival (PFS), and locoregional control (LC) rates (p > 0.05). For elderly early-stage NSCLC patients with acceptable risk, surgery remains the more appropriate treatment method. For patients unable to undergo surgery or who refuse it, SBRT serves as a viable alternative treatment option.