title: Long-term quality of life in early-stage non-small cell lung cancer patients treated with robotic stereotactic ablative radiation therapy.
abstract: OBJECTIVE
  The purpose of this study was to prospectively evaluate the quality of life (QoL) and pulmonary function of patients with early-stage non-small cell lung cancer treated with robotic stereotactic ablative radiation therapy (SABR).
  
  
  METHODS
  Eligible patients all had histologically confirmed stage I non-small cell lung cancer and were not surgical candidates because of poor pulmonary function, comorbidities, or refusal of surgery. SABR was delivered at a median dose of 60 Gy in 3 fractions for peripheral tumors and 50 Gy in 4 or 5 fractions for central tumors. QoL was scored using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (QLQ-C30) and Lung Cancer-13 questionnaires. Pulmonary function tests (PFTs) included forced expiratory volume in 1 second (FEV1) and lung diffusion capacity. Changes over time in QoL scores and PFTs were tested with nonparametric tests for longitudinal data. Local control, survival, and toxicities are also presented.
  
  
  RESULTS
  From January 2010 to May 2013, 45 patients were enrolled. Median follow-up was 41 months. QLQ-C30 mean baseline scores for global QoL and physical functioning were 66 ± 20% and 73 ± 22%. Multilevel analyses showed no statistically and clinically significant (10-point change) deterioration in any of the QoL scores after SABR. Mean baseline FEV1 was 1.39 ± 0.51 L, and mean lung diffusion capacity was 63 ± 25% of predicted. We saw no significant change in PFTs at any time point. At 3 years, local control, disease-free survival, and overall survival were, respectively, 94%, 67%, and 75%.
  
  
  CONCLUSIONS
  In nonsurgical patients with multiple comorbidities, lung SABR achieves long-term local control while maintaining QoL and pulmonary function.
authors: Radiation Oncology Department, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
authors: Dominique
authors: D
authors: Mathieu
authors: Radiation Oncology Department, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
authors: Marie-Pierre
authors: MP
authors: Campeau
authors: Radiation Oncology Department, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
authors: Houda
authors: H
authors: Bahig
authors: Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana.
authors: Sandra
authors: S
authors: Larrivée
authors: Radiation Oncology Department, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
authors: Toni
authors: T
authors: Vu
authors: Radiation Oncology Department, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
authors: Louise
authors: L
authors: Lambert
authors: Radiation Oncology Department, Centre Hospitalier Universitaire de Québec, Québec, Québec, Canada.
authors: Caroline
authors: C
authors: Lavoie
authors: Radiation Oncology Department, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
authors: David
authors: D
authors: Roberge
authors: Radiation Oncology Department, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
authors: Robert
authors: R
authors: Doucet
authors: Radiation Oncology Department, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
authors: Jean-François
authors: JF
authors: Carrier
authors: Radiation Oncology Department, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
authors: Andrei
authors: A
authors: Gorgos
authors: Radiation Oncology Department, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
authors: Bernard
authors: B
authors: Fortin
authors: Radiation Oncology Department, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada. Electronic address: edith.filion.chum@ssss.gouv.qc.ca.
authors: Edith
authors: E
authors: Filion
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000401:mortality / Q000523:psychology* / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000523:psychology* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011881:Radiotherapy, Computer-Assisted / Q000379:methods*; D065287:Robotic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome