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. 2022 Nov:8:e2200061.
doi: 10.1200/GO.22.00061.

Real-World Evidence of Health Outcomes Related to Lung Stereotactic Body Radiation Therapy in Brazil

Lilian Faroni  1   2 , Carlos Gil Ferreira  3 , Fabio Moraes  4 , Clarissa Baldotto  1   2 , Mauro Zukin  1 , Veronica Aran  5 , Luiz Henrique Araujo  1
Affiliations

Real-World Evidence of Health Outcomes Related to Lung Stereotactic Body Radiation Therapy in Brazil

Lilian Faroni et al. JCO Glob Oncol. 2022 Nov.

Abstract

Purpose: Stereotactic body radiation therapy (SBRT) is an effective option for patients with both early-stage and oligometastatic non-small-cell lung cancer (NSCLC). However, data from Latin America are limited. Therefore, the aim of this study was to investigate the real-world outcomes of applying SBRT for lung lesions in a Brazilian institution.

Methods: This study investigated a consecutive cohort of patients treated with SBRT for lung lesions (primary and metastasis). The study primary outcome was local control rates per lesion. Secondary outcomes included progression-free survival (PFS), overall survival (OS), and toxicity.

Results: Between 2015 and 2019, a total of 216 patients received SBRT and were included in the study. The median follow-up was 24.5 months (5-70), primary NSCLC corresponded to 70% (n = 151) and nonprimary lung lesions to 30% (n = 65), respectively. Stage I NSCLC represented 56% (85 of 151) of the NSCLC cohort. The average number of fractions and total dose prescribed was 5 (3-10)/59 Gy (50-62 Gy). For stage I NSCLC (all lesions treated with a biologically effective dose [10] > 100 Gy), 2-year local control, OS, and PFS were 93.4%, 81.6%, and 80.7%, respectively. For stage IV lesions, if biologically effective dose (10) > 100 Gy or < 100 Gy, 2-year local control was 95.8/86.4% (P = .03), 2-year-OS was 81.6/60.5% (P = .006), and 2-year PFS was 38.9/17.9% (P = .10). Late toxicity was observed in 16.2% (n = 35) of the total cases.

Conclusion: Our results indicate that SBRT is effective (high local control and acceptable toxicity) for treating malignant lung lesions in a real-world scenario in Latin America.

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Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/go/authors/author-center.

Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).

Fabio Moraes

Honoraria: AstraZeneca Canada

Consulting or Advisory Role: Elekta

Clarissa Baldotto

Honoraria: AstraZeneca, MSD Oncology Brazil, Roche Oncology Brazil, Takeda Oncology Brazil, BMS Brazil, Janssen Oncology Brazil, Pfizer Oncology Brazil, MD Health

Consulting or Advisory Role: MSD, AstraZeneca, Janssen Oncology Brazil, Novartis, Takeda Brazil, Roche Oncology Brazil

Speakers' Bureau: Roche Oncology Brazil, BMS Brazil, Janssen Oncology Brazil, MSD, Instituto D'Or de Pesquisa e Ensino

Research Funding: AstraZeneca, Roche/Genentech, Janssen Oncology

Travel, Accommodations, Expenses: Janssen Oncology

Mauro Zukin

Honoraria: Janssen Oncology, Roche Brazil, Lilly Brazil, AstraZeneca Brazil, Wyeth Brazil, Novartis Brazil

Consulting or Advisory Role: Janssen Oncology Panama

Speakers' Bureau: Roche, AstraZeneca, Janssen Oncology

Travel, Accommodations, Expenses: Mundipharma, MSD Oncology, Roche, BMS Brazil, MSD Oncology

Luiz Henrique Araujo

Consulting or Advisory Role: Merck Sharp & Dohme, Bristol Myers Squibb, AstraZeneca, Pfizer, Boehringer Ingelheim, Merck, Roche

Speakers' Bureau: AstraZeneca, Pfizer, Merck, Roche, Merck Sharp & Dohme, Bristol Myers Squibb, Boehringer Ingelheim

Research Funding: Merck Sharp & Dohme (Inst), Bristol Myers Squibb (Inst), AstraZeneca (Inst), Pfizer (Inst), Merck (Inst), Roche (Inst), Boehringer Ingelheim (Inst)

No other potential conflicts of interest were reported.

Figures

FIG 1
FIG 1
Plot of age distribution over stages in patients with NSCLC. The average age of stage I patients was greater than stage IV patients (P < .0001). NSCLC, non–small-cell lung cancer.
FIG 2
FIG 2
(A-C) The 2-year analysis evaluating LC, OS, and PFS for patients with stage I and IV NSCLC; (D-F) for patients with stage IV lung and nonlung; and (G-I) for BED (10) > or < 100 Gy in all stage IV patients. BED, biologically effective dose; LC, local control; NSCLC, non–small-cell lung cancer; OS, overall survival; PFS, progression-free survival.()
FIG 2
FIG 2
(A-C) The 2-year analysis evaluating LC, OS, and PFS for patients with stage I and IV NSCLC; (D-F) for patients with stage IV lung and nonlung; and (G-I) for BED (10) > or < 100 Gy in all stage IV patients. BED, biologically effective dose; LC, local control; NSCLC, non–small-cell lung cancer; OS, overall survival; PFS, progression-free survival.()
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