Positive Impact of Hypertension in Patients with Early-stage Lung Cancer Treated With Stereotactic Body Radiotherapy

Background/Aim: This study aimed to analyze the effect of hypertension on recurrence and progression-free survival (PFS) in patients with early-stage lung cancer who underwent curative stereotactic body radiotherapy (SBRT). Patients and Methods: This study included 100 patients with T1-T3N0M0 lung cancer who underwent lung SBRT using CyberKnife or volumetric-modulated arc therapy at Inha University Hospital between July 2008 and June 2025. Recurrence rates and PFS were analyzed. Data on hypertension and specific types of antihypertensive medications were retrospectively reviewed from electronic medical records. Results: The median follow-up period was 31.0 months (range=0.7-136.7 months). Of the 100 patients, 52 had hypertension. Recurrence occurred in 38 patients, including 25 with locoregional failure and 13 with distant metastases. Recurrence rates were significantly lower in patients with hypertension (p=0.015), with reduced locoregional recurrence (p=0.022), whereas distant metastasis showed no significant correlation with hypertension (p=0.315). Hypertensive drug users (n=37) had lower recurrence rates (p=0.003). Recurrence was higher in male patients (p=0.049) and lower in those aged >70 years (p=0.033). Patients with hypertension showed significantly improved PFS (p=0.010) but no difference in overall survival based on hypertension status (p=0.319). Other factors that positively affected PFS included female sex and age >70 years. Patients actively receiving antihypertensive medication showed greater PFS than those who did not (p=0.016). In particular, those using beta-blockers showed a low recurrence rate (0%, p=0.033). Conclusion: The therapeutic effects of lung SBRT appear more pronounced in patients with hypertension. This favorable outcome may be related to the administration of antihypertensive medications, suggesting the need for further investigation into the underlying mechanisms.