Report Shows Value of Community Cancer Centers in SBRT Treatment
A new study offers further confirmation of the value community-based radiosurgery facilities bring to cancer treatment, demonstrating an adherence to established treatment guidelines and outcomes that compare with larger academic institutions.
Titled “Stereotactic body radiotherapy for early-stage non-small cell lung cancer: clinical outcomes from a National Patient Registry,” the study appeared in the January 2015 edition of the Journal of Radiation Oncology.
To analyze practices and outcomes reflective of a real-world setting, the study sought to assess the impact of stereotactic body radiation therapy (SBRT) on early-stage, specifically T1-T2, non-small cell lung cancer (NSCLC) from a national patient registry.
Using the RSSearch® Patient Registry, researchers at 10 community cancer centers throughout the United States screened the database for early-stage NSCLC patients treated with SBRT from May 2004 to May 2013.
Dr. David D’Ambrosio, medical director of New Jersey CyberKnife at Community Medical Center (CMC) in Toms River, N.J., served as a study co-author. An Alliance Oncology facility dedicated to radiosurgery treatment, New Jersey CyberKnife is part of the J. Phillip Citta Regional Cancer Center at CMC.
New Jersey CyberKnife is one of a number of Alliance Oncology facilities heavily engaged in clinical research, helping grow the number of publications assessing radiosurgery treatment for different types of malignant and benign conditions.
Regarding the study he helped co-author, Dr. D’Ambrosio says it demonstrates several key aspects of radiosurgery performed at the community center level, including uniform delivery of treatment, along with patient outcomes that were comparable to trials published in the United States, Europe and Japan.
“The findings show community cancer centers are not only following the appropriate guidelines and standards of care, but the results are very comparable to what you’re seeing from academic institutions,” Dr. D’Ambrosio says. “It helps not only for us to do self-examination of how our center compares to other community-based centers but also to compare our results directly in a standardized manner to academic centers across the country.”
The observational registry study was conducted with an impressive number of patients – 723 treated for NSCLC during a 10-year period that ended in May 2013. The patients had been diagnosed with smaller tumors classified as T1, no larger than 3 centimeters across and not yet in the membranes surrounding the lungs, and T2, between 3 and 7 centimeters across and beginning to affect the lung tissues.
Descriptive analyses were used for patient, tumor and treatment characteristics, while the Kaplan-Meier method was used to calculate overall survival and local control. Results showed a median overall survival rate of 29 months – 30 months for T1 and 26 months for T2 – with a one-year survival rate of 85 percent. Those figures are in line, the researchers said, with results from more formal, single-institution studies.
As strong advocates for cancer patient registries and the value they lend to research reflective of real-world settings, Dr. D’Ambrosio and the New Jersey CyberKnife clinical team has enrolled more patients in the RSSearch® Patient Registry than any other single institution in the world. He says observational studies made possible by registries are poised to yield new insights into SBRT and other radiosurgery techniques.
“Registries provide a really good and simple way for physicians to collaborate,” he says. “Participation in a registry also provides the ability to extract data for your own publication.”
The latest study follows results of another released in late 2013 that also included Dr. D’Ambrosio as a co-author and focused on the RSSearch® registry.
That study also reached several important conclusions, showing that community cancer centers participating in RSSearch® are following established guidelines for SBRT treatment of prostate cancer. In addition, it demonstrated the value of prospective cancer registries, especially in tracking patient demographics, treatment management practices and clinical outcomes.
Dr. D’Ambrosio plans to get involved with similar collaborative studies with the Radiosurgery Society, focusing on other disease sites.
“These types of registry studies are very important for CyberKnife and SBRT because there’s not much published material on each individual disease site,” Dr. D’Ambrosio says. “This kind of study shows good results and reinforces that this is a safe treatment. It also provides a solid framework for outlining what’s appropriate in the delivery of treatment and for advancing the modality as an option for different types of diseases.”
In addition to patient care, research is one of Dr. D’Ambrosio’s main interests and passions. Taking part in clinical studies benefits all cancer patients, and it helps demonstrate that New Jersey CyberKnife is constantly evolving and maintaining the highest quality of care, he says.
“As a self-assessment tool, research is also important to ensure that we’re meeting the benchmarks that are published by other centers.”
He credited Alliance Oncology’s efforts in fostering collaborative studies among the company’s network of centers, more than half of which are dedicated to radiosurgery. With one of the largest databases of radiosurgery clinical benchmarks available, Alliance Oncology partner centers like New Jersey CyberKnife have access to robust clinical data and benchmarking capabilities, an advantage made possible by Alliance’s proprietary SMART data system.
“One of the main benefits of being part of the Alliance Oncology network is the ability to share research, software and to collaborate with other physicians and physicists who have a wide range of expertise,” Dr. D’Ambrosio says. “There’s a level of collaboration that benefits you as a treating physician, as a physicist and obviously our patients who are most important.”