Background: Deterioration in health-related quality of life (HRQOL) is frequently observed after surgery for stage I non-small-cell
lung cancer. As stereotactic ablative radiotherapy (SABR) can result in local control percentages exceeding 90%, we studied
baseline and post-treatment HRQOL in SABR patients.
Methods: HRQOL data were collected prospectively using the European
Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire in 382 consecutive patients treated with SABR.
Patients were referred from 68 Dutch centers, with 86% judged unfit for surgery, and 14% declining surgery. An SABR dose of
60 Gy was delivered in three-, five-, or eight treatment fractions, depending on tumor diameter and location. HRQOL data were
available for 382 patients at baseline (pre-SABR), and for 282, 212, 144, 56, and 43 patients at 3, 6, 12, 18, and 24 months
Results: Median survival was 40 months, with a 2-year survival of 66%. Local, regional,
and distant failure percentages at 2 years were 6%, 13%, and 22%, respectively. Mean baseline global HRQOL and physical functioning
scores were 62.9 ± 1.1 and 61.7 ± 1.1, respectively. Baseline symptom scores were highest for dyspnea (47.1 ± 1.7) and fatigue
(37.4 ± 1.3). Except for a nonsignificant decrease in 2 to 3 points per year in physical functioning, no statistically or
clinically significant worsening of any of the HRQOL functioning or symptom scores at any follow-up time point was observed.
Patients referred for SABR have substantially worse baseline HRQOL scores than those reported in the surgical literature.
Clinically relevant deteriorations in HRQOL subscale scores were not observed after SABR.