(S038) Do Race or Income Influence Quality of Life (QOL) or Survival (OS) After Lung Stereotactic Body Radiotherapy (SBRT) in Stage I Non-Small Cell Lung Cancer? A Prospective Study

This prospective clinical study focused on the hypothesis that there would be no difference in survival or QOL based on race or income when patients with stage I NSCLC are treated with lung SBRT in a center with a multidisciplinary approach. This IRB-approved study was designed to evaluate changes in QOL using the following validated instruments: EuroQOL-EQ-5D index, EQ-5D-Visual Analog Scale (EQ-5D VAS), and FACT Trial-Outcome-Index (FACT-TOI). Responses at baseline, immediately post-treatment, and at 3 and 6 months post-SBRT were available for analysis. Median household income (MHHI) was estimated at the census tract group level. Changes in QOL across time points were calculated using paired t-tests. Survival was assessed using Kaplan-Meier analysis. 54 patients (36 T1; 18 T2) had at least 6 month follow-up and were included for analysis. Median follow-up was 1.34 years. African Americans (AA) represented 33% of the study cohort, 67% of patients were Caucasians. Most common fractionation was 12 Gy x 4 fractions. MHHI of the cohort was $32,328 and was used to stratify high vs low income. The calculated EQ-5D index, EQ-5D VAS, and FACT-TOI for the entire cohort of patients showed that there was no difference relative to baseline for each of the QOL scores at any of the time points (immediately post-treatment and at 3 and 6 months). Similar comparisons, after stratifying by race and MHHI, again failed to identify any significant differences. Kaplan-Meier analysis showed no differences in OS when stratified by race (p=0.18) or by median household income (p=0.26). The overall survival was excellent (91% at 1-year and 78% at 3-years) with no significant decline in QOL over the first 6 months post-SBRT. In this multidisciplinary care setting, OS and QOL were not influenced by race or income at any timepoint in the 6 months following lung SBRT.