Quality of Life After Stereotactic Ablative Radiotherapy for Early-Stage Lung Cancer: A Systematic Review

Patient-reported outcomes are increasingly important in the evaluation of cancer treatment modalities. We systematically reviewed the existing published data on patient-reported health-related quality of life (HRQOL) after stereotactic ablative radiotherapy (SABR) for early-stage nonesmall-cell lung cancer. Nine studies were analyzed, and our results showed that most HRQOL domains were preserved after SABR. Possible deteriorations in dyspnea and fatigue were noted. Background: Stereotactic ablative radiotherapy (SABR) has recently become the guideline-recommended therapy for inoperable patients with early-stage nonesmall-cell lung cancer (ES-NSCLC) and for patients who decline surgery. Patient-reported outcomes should be a key consideration for any treatment modality; however, to our knowledge, a systematic review of the effects of SABR on health-related quality of life (HRQOL) in this patient population is not yet available. Materials and Methods: The Embase and MEDLINE databases were queried to obtain journal studies investigating patient-reported HRQOL after SABR for ES-NSCLC. Studies in the English language were included up to August 1, 2015. Relevant data regarding patient characteristics and study outcomes were abstracted and analyzed. Results: Of the 204 potential studies, 9 met all the inclusion criteria and their data were analyzed. All the studies were prospective in design, ranged in date from 2010 to 2015, and involved patients from Europe and North America. The reviewed studies reported few clinically significant changes in HRQOL scores after SABR. Clinically and statistically significant deteriorations in fatigue and dyspnea were individually reported in 2 studies, but these findings were not replicated by other studies. Conclusion: Post-treatment HRQOL scores indicate that SABR is an overall well-tolerated modality for patients with ES-NSCLC who either declined or were unfit for surgery. Future clinical trials comparing SABR and surgery would benefit from the inclusion of HRQOL metrics in the study design. (C) 2015 Elsevier Inc. All rights reserved.