Research Activities, August 2013
Insufficient evidence to compare effectiveness of local, nonsurgical therapies for stage I non-small cell lung cancer or airway-obstructive lung tumors
Comparative Effectiveness Research
There is not enough evidence in the research literature to determine the relative effectiveness (e.g., symptom relief, survival, disease control) and harms (e.g., treatment-related toxicities) of local, nonsurgical therapies to treat patients with stage I non-small cell lung cancer (NSCLC) or patients with airway obstruction from advanced lung tumors, according to an AHRQ research review.
Although surgery is the standard of care for patients with stage I NSCLC, those who are either deemed inoperable or decline surgery may be treated with local, nonsurgical therapies such as radiotherapy, intensity-modulated radiation therapy, and stereotactic body radiation therapy (SBRT).
The largest body of evidence for local, nonsurgical therapies in patients with stage I disease is on SBRT, also known as stereotactic ablative radiotherapy. This suggests it may be gaining popularity among clinicians as a preferred treatment. However, there is not enough high-quality evidence available to determine the relative effectiveness of one therapy over another.
Ultimately, the review highlights the need for additional clinical studies that directly compare local, nonsurgical therapies, especially considering that NSCLC is the leading cause of cancer-related mortality in the United States and worldwide.
These findings are available in the research review, Local Nonsurgical Therapies for Stage I and Symptomatic Obstructive Non–Small-Cell Lung Cancer, at http://go.usa.gov/jbsP.