Surgery versus SABR for early-stage lung cancer - time to call it a draw?
Mené entre 2015 et 2017 sur 80 patients atteints d'un cancer du poumon non à petites cellules de stade précoce (durée médiane de suivi : 5,1 ans), cet essai évalue l'efficacité, du point de vue de la survie globale à 3 ans, et la sécurité d'une radiothérapie stéréotaxique d'ablation
Randomised controlled trials comparing surgery with non-surgical treatment for cancer have been notoriously difficult to complete, owing to challenges in both equipoise and preference in patients and providers alike. Debate on the relative merit of stereotactic ablative radiotherapy (SABR) versus surgery for early-stage non-small-cell lung cancer (NSCLC) is no exception. Prospective randomised controlled trials designed to identify a so-called winner between surgery and SABR have not been able to accrue, and the pooled analysis from the prematurely closed original STARS and ROSEL studies has been a lightning rod for discussion among thoracic oncologists. Even with other comparative effectiveness studies attempting to adjust for confounding, inherent limitations engender polarising opinions.
The Lancet Oncology , commentaire en libre accès, 2020