“Never too old”: A single-institution experience of stereotactic body radiotherapy for patients 90years and older with early stage lung cancer

Publication date: Available online 29 June 2017
Source:Practical Radiation Oncology
Author(s): Gregory M.M. Videtic, Neil M. Woody, Chandana A. Reddy, Kevin L. Stephans
PurposeTo report on the patient, tumor and treatment characteristics of patients aged 90years and older treated with lung stereotactic body radiotherapy (SBRT) for their early stage lung cancer and the resulting clinical outcomes:MethodsWe surveyed our IRB-approved prospective lung SBRT data registry for patients treated for early stage lung cancer who were aged 90years or more in order to determine rates of local failure (LF), progression-free survival (PFS) and overall survival (OS), as well as treatment-related toxicity.ResultsFor the interval 2004–2016, 19 patients (of a total 1268 lung SBRT cases) were identified. The median age at treatment was 91.6years (range 90–97). The majority of patients was female (52.6%) and former smokers (78.9%). The median tumor size was 2.1cm (range 1.5–5.4). Tissue was obtained for diagnosis in 68.4% with the predominant histology being adenocarcinoma (42.2%). Six (31.6%) patients had "central" lesions. Median follow up for all patients was 17.3months. The median SBRT schedule was 50Gy in 5 fractions over 5 consecutive days and used in 9 cases (47.4%). Median pre- and 6 –month post-SBRT pulmonary testing showed FEV1 as % predicted of 81.9 and 84.5, and DLCO as % predicted of 66.5 and 67, respectively. No grade 3 or higher toxicities were observed. Two-year rates (in %) of LF, PFS, and OS were 5.6, 48.6, and 47.8, respectively.ConclusionsLung SBRT appears safe and effective in nonagenarians with stage I lung cancer and given the absence of high grade toxicities and mortality, warrants its consideration as the primary curative modality in this population.



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