Top Line: The LUSTRE trial demonstrated comparable local control at 3 years with either SBRT (88%) or hypofractionated radiation (81%) for stage I non-small cell lung cancer (NSCLC).
The Study: A pre-planned secondary analysis delves into patient-reported quality-of-life as measured prospectively for two years using validated questionnaires. At 2 weeks—the acute toxicity peak—SBRT showed modestly better global health (+4 points) and fewer lung cancer–specific symptoms (–1.4 points). But by 24 months, all domains converged with small numerical advantages favoring hypofractionated radiation that did not reach clinically-meaningful thresholds. Late toxicity was low and comparable overall, with notably worse outcomes in central/ultracentral SBRT cases.
TBL: SBRT buys a small early quality-of-life edge thanks to its shorter course, but long-term well-being looks similar when compared to 15-fraction hypofractionation. For higher-risk central lesions, hypofractionation remains the safer alternative. | Hou, Int J Radiat Oncol Biol Phys 2025
The Study: A pre-planned secondary analysis delves into patient-reported quality-of-life as measured prospectively for two years using validated questionnaires. At 2 weeks—the acute toxicity peak—SBRT showed modestly better global health (+4 points) and fewer lung cancer–specific symptoms (–1.4 points). But by 24 months, all domains converged with small numerical advantages favoring hypofractionated radiation that did not reach clinically-meaningful thresholds. Late toxicity was low and comparable overall, with notably worse outcomes in central/ultracentral SBRT cases.
TBL: SBRT buys a small early quality-of-life edge thanks to its shorter course, but long-term well-being looks similar when compared to 15-fraction hypofractionation. For higher-risk central lesions, hypofractionation remains the safer alternative. | Hou, Int J Radiat Oncol Biol Phys 2025