All-cause hospital admissions after stereotactic ablative body radiotherapy for primary lung cancer

ABSTRACT

Category Outcomes of treatment (including chemotherapy, chemo-RT and RT) Purpose: Stereotactic ablative body radiotherapy (SABR) and lung resection are both effective treatments for early lung cancer. The UK National Lung Cancer Audit has shown low mortality after thoracic surgery but a high 90-day all-cause hospital readmission rate of 41%. The aim of this study was to evaluate hospital admissions after SABR for primary lung cancer. Methods and materials Hospital records of patients treated with SABR for primary lung cancer between October 2012 and October 2021 at Royal Free Hospital were retrospectively reviewed. Result(s) 152 patients were identified. The median age was 78 years (range 40-95). Biopsy confirmation rate was 78%. Most patients had T1 tumours (87%). Treatment was with 5# (65%), 3# (19%) and 8# (16%). Ultracentral lesions were not treated. Multiple lesions were treated in ten patients. The median follow-up was 21 months. Oncological outcomes were excellent with a 95% local control rate, 11% distant recurrence, one-year overall survival 92% and two-year overall survival 80%. There was one death within 30 days of treatment due to decompensated cirrhosis in a patient with chronic liver disease. 15 patients (10%) were admitted to hospital within 90 days of SABR treatment. Causes of hospital admission were * Chest sepsis - 6 (including 1 COVID) * Heart failure - 2 (known cardiac disease) * Decompensated cirrhosis - 1 * Line infection - 1 * Oesophageal reflux - 1 * Miscellaneous surgical - 4 Conclusion(s) SABR is a highly effective and well-tolerated treatment for early lung cancer. The 90-day all-cause hospital admission rate in this cohort was 10%. These hospital admissions were not a direct consequence of SABR, and the majority were due to respiratory and cardiac co-morbidity. This highlights the need for smoking cessation and medical optimisation of co-morbidities in this patient group. Copyright © 2022