Ashwin Ganesh

For patients with early-stage non-small cell lung cancer (eNSCLC), increased use of stereotactic body radiation therapy (SBRT) was linked with a decrease in racial disparities and mortality, according to a study published in Clinical Lung Cancer.

“Traditionally, early-stage lung cancer has been treated with surgical resection,” Ashwin Ganesh and colleagues wrote. “However, studies have previously determined disparities in the receipt of treatment by race.”

For the past two decades, national guidelines have strongly endorsed the use of SBRT for the treatment of patients with early-stage lung cancer who are not candidates for surgery. “Due to the increased utilization of SBRT, we sought to determine if the use of this modality had changed previous disparities in the receipt of treatment for early-stage lung cancer,” the study authors wrote. “Furthermore, we sought to determine if the increased use of SBRT had translated into a change in mortality from early-stage lung cancer across the United States.”

Using the National Cancer Database, the researchers assessed the proportion of patients with NSCLC receiving SBRT, surgery, or no definitive treatment. Using the SEER database, they calculated age-adjusted mortality rates; univariable and multivariable logistic regressions were utilized.

Reduced Racial Disparity Linked With Drop in Lung Cancer-Related Mortality

Ganesh and colleagues observed that from 2004 to 2017, the percentage of patients with eNSCLC undergoing no definitive treatment declined from 22% to 10.5% (P<0.001). During that same period, the percentage of patients treated with SBRT increased from 1% to 22% (P<0.001).

Compared with Black patients, who showed a greater decrease of 32% to 15% (P<0.001), the percentage of White patients undergoing no definitive treatment dropped from 21% to 10% (P<0.001). Among Black patients, the percentage receiving SBRT grew from 1% to 22% (P<0.001). Compared with White patients, the likelihood of Black patients receiving curative therapy increased between 2011 and 2017 (OR, 0.55-0.70; P<0.001]. In addition, the age-adjusted mortality rate of early-stage NSCLC dropped from 4.3 in 2004 to 0.8 in 2017 (P<0.001).

“This analysis shows racial disparities in terms of receipt of curative therapy for eNSCLC from 2004 to 2017 had decreased,” Ganesh and colleagues wrote. “This decrease in the magnitude of racial disparities was associated with a decrease in lung cancer-related mortality in the US population, [and] these changes were due to the increased usage of SBRT in lung cancer therapy during this period.”