Quality of Life of Stereotactic Versus Hypofractionated Radiation Therapy for Inoperable Stage I Non-Small Cell Lung Cancer: Results From the LUSTRE Trial
Bibliographic record
Abstract
PURPOSE: There is limited evidence on quality-of-life (QoL) outcomes of stereotactic body radiation therapy (SBRT) compared with conventionally hypofractionated radiation therapy (CHRT) in patients with medically inoperable stage I (≤5 cm) non-small cell lung cancer (NSCLC). METHODS AND MATERIALS: This phase 3 randomized trial was conducted across 16 Canadian centers, enrolling patients with medically inoperable stage I (≤5 cm) NSCLC. Participants were randomized in a 2:1 ratio to receive SBRT or CHRT. QoL was assessed over 2 years postrandomization using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the lung cancer-specific module 13 (LC-13), evaluating physical, symptom, functional, and social well-being. Differences in QoL between treatment groups at 2 weeks and 2 years were analyzed using linear mixed models, adjusting for baseline scores and stratification variables. RESULTS: Of the 233 patients, 154 received SBRT and 79 received CHRT. At 2 weeks, model estimated mean global health scores were higher in the SBRT group (68.93 vs 64.93), with an estimated mean difference of 4.00 (95% CI 3.12, 4.89, P < .01). At 24 months, global health scores were 59.96 for SBRT and 62.88 for CHRT, with a difference of -2.92, 95% CI: -3.73, -2.11, P < .01). Mean LC-13 symptom scores at 2 weeks were 15.70 for SBRT and 17.11 for CHRT, with a difference of -1.41 (95% CI: -1.87, -0.95, P < .01). Mean difference in LC-13 at 24 months was 0.14 (95% CI: -0.29, 0.57, P = .69). CONCLUSIONS: SBRT offers modest benefit in acute QoL and similar benefit in long-term QoL compared with CHRT in patients with inoperable stage I NSCLC.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.004 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".