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Stereotactic ablative radiotherapy (SABR) is the standard non-surgical management for peripheral early lung cancers. Existing literature suggest SABR is safe in patients with poor lung function. This study evaluates the effect of lung function on survival outcomes for patients treated with SABR.

All patients who received SABR at a large cancer centre in the UK from 01/01/2010 to 31/12/2016 were reviewed. Patients were included if they had pre-SABR full pulmonary function tests (PFTS) which include forced expiratory volume in one second (FEV1), FEV1 as a percentage of predicted (%FEV1), forced vital capacity (FVC) and DLCO as a percentage of predicted (%DLCO). Patient and tumour demographics were obtained for each patient from electronic health records. Survival times were calculated and analysed using SPSS statistics.

410 patients with complete medical records and pre-SABR PFTs were included in the study. Median follow up was 26.1 months. Patient and cancer demographics are summarised in table 1. Median overall survival for the whole cohort was 29.7 months. %DLCO was found to be associated with worse overall survival (cox regression, p=0.001). Performance status and age were also found to be associated with worse survival (p=0.035 and p<0.001 respectively). Overall survival of patients with  %DLCO>50% of was 31.9 month, versus 25 months (log rank p=0.011) for patients with %DLCO <50%.

Table 1

Graph 1

Poor %DLCO was found to be associated with poor overall survival in this study. Further studies using radiation dosimetry and additional co-morbidity factors are needed to clarify true correlation and post SABR survival.