Henri B Wolff1, Leonie Alberts2, Elisabeth A Kastelijn3, Birgit I Lissenberg-Witte4, Jos W Twisk4, Frank J Lagerwaard5, Suresh Senan5, Sherif Y El Sharouni6, Franz M N H Schramel2, Veerle M H Coupé4. 1. Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, The Netherlands. Electronic address: h.wolff@vumc.nl. 2. Department of Pulmonology, St. Antonius Hospital, Nieuwegein, The Netherlands. 3. Department of Pulmonology, Gelderse Vallei Hospital, Ede, The Netherlands. 4. Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, The Netherlands. 5. Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands. 6. Department of Radiotherapy, University Medical Centre Utrecht, Utrecht, The Netherlands.
Abstract
INTRODUCTION: There is an ongoing debate on the optimal treatment for stage I NSCLC, with increasing evidence for comparable health outcomes after surgery and stereotactic body radiation therapy (SBRT). For clinical decision making, the experienced quality of life, summarized as health utility, is of importance to choosing between treatments. In this study, we evaluated differences in longitudinal health utility in stage I NSCLC in the first year after surgical resection versus after SBRT before any recurrence of disease. We also assessed the impact of potential prognostic variables on health utility. METHODS: Prospectively collected databases containing data on patients with stage I NSCLC treated with either SBRT or surgery were pooled from two large hospitals in the Netherlands. Quality of life data were measured by the Quality of Life Questionnaire-Core 30 questionnaire at baseline and 3, 6, and 12 months after treatment. Health utility (measured using the European Quality of Life Five-Dimension questionnaire) was calculated from the Quality of Life Questionnaire-Core 30 questionnaire by using a mapping algorithm. Propensity score matching was used to adjust for selection bias. Treatment effects were estimated for the matched patients by using a longitudinal mixed model approach. RESULTS: After correction for Eastern Cooperative Oncology Group score, sex, and age, the difference in 1-year averaged health utility between the SBRT and surgery groups was 0.026 (95% confidence interval: 0.028-0.080). Differences in health utility decreased over time. CONCLUSIONS: A small but not statistically significant difference in health utility was found between patients with stage I NSCLC treated with surgery and those treated with SBRT. Current analysis strengthens existing evidence that SBRT is an equivalent treatment option for early-stage NSCLC. Comparative cost-effectiveness remains to be determined.
INTRODUCTION: There is an ongoing debate on the optimal treatment for stage I NSCLC, with increasing evidence for comparable health outcomes after surgery and stereotactic body radiation therapy (SBRT). For clinical decision making, the experienced quality of life, summarized as health utility, is of importance to choosing between treatments. In this study, we evaluated differences in longitudinal health utility in stage I NSCLC in the first year after surgical resection versus after SBRT before any recurrence of disease. We also assessed the impact of potential prognostic variables on health utility. METHODS: Prospectively collected databases containing data on patients with stage I NSCLC treated with either SBRT or surgery were pooled from two large hospitals in the Netherlands. Quality of life data were measured by the Quality of Life Questionnaire-Core 30 questionnaire at baseline and 3, 6, and 12 months after treatment. Health utility (measured using the European Quality of Life Five-Dimension questionnaire) was calculated from the Quality of Life Questionnaire-Core 30 questionnaire by using a mapping algorithm. Propensity score matching was used to adjust for selection bias. Treatment effects were estimated for the matched patients by using a longitudinal mixed model approach. RESULTS: After correction for Eastern Cooperative Oncology Group score, sex, and age, the difference in 1-year averaged health utility between the SBRT and surgery groups was 0.026 (95% confidence interval: 0.028-0.080). Differences in health utility decreased over time. CONCLUSIONS: A small but not statistically significant difference in health utility was found between patients with stage I NSCLC treated with surgery and those treated with SBRT. Current analysis strengthens existing evidence that SBRT is an equivalent treatment option for early-stage NSCLC. Comparative cost-effectiveness remains to be determined.
Authors: David A Palma; Timothy K Nguyen; Alexander V Louie; Richard Malthaner; Dalilah Fortin; George B Rodrigues; Brian Yaremko; Joanna Laba; Keith Kwan; Stewart Gaede; Ting Lee; Aaron Ward; Andrew Warner; Richard Inculet Journal: JAMA Oncol Date: 2019-05-01 Impact factor: 31.777
Authors: Christine M Cramer-van der Welle; Lotte van Loenhout; Ben Eem van den Borne; Franz Mnh Schramel; Lea M Dijksman Journal: BMJ Open Date: 2021-01-15 Impact factor: 2.692
Authors: Geoffrey Liu; Grainne M O'Kane; Ali Vedadi; Sharara Shakik; M Catherine Brown; Benjamin H Lok; Frances A Shepherd; Natasha B Leighl; Adrian Sacher; Penelope A Bradbury; Wei Xu Journal: Qual Life Res Date: 2020-08-26 Impact factor: 3.440