Stereotactic Ablative Radiotherapy is a Highly Safe and Effective Treatment for Elderly Patients with Early Stage Non-Small Cell Lung Cancer

Publication date: Available online 21 December 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Eric D. Brooks, Bing Sun, Lina Zhao, Ritsuko Komaki, Zhonxing Liao, Melenda Jeter, James W. Welsh, Michael S. O'Reilly, Daniel R. Gomez, Stephen M. Hahn, John V. Heymach, David C. Rice, Joe Y. Chang
PurposeTo discern the efficacy and toxicity of SABR in the elderly population (age ≥75), and to consider how it compares to surgical outcomes historically reported in the elderly.Methods and Materials772 patients with clinically early-stage I-II NSCLC (T1-T3 N0M0) were treated with SABR (50 Gy in 4 fractions or 70 Gy in 10 fractions) between 2004-2014 at our center (n=442 age <75, n=330 age ≥75). Primary end points included overall survival, time-to-progression, and grade ≥3 toxicity. Median follow-up time was approximately 55 months.ResultsCompared to patients age <75, patients age ≥75 had no difference in time-to-progression (p=0.419), lung cancer-specific survival (p=0.275), or toxicity (p=0.536). Overall survival was the same between both age groups at 2-years of follow-up but diverged thereafter, with patients aged <75 when treatment began having higher overall survival rates at 5 years. Median OS rates for patients age ≥75 were 86% at 1 year, 57.5% at 3 years, and 39.5% at 5 years. Median OS rates for patients age <75 were 87.3% at 1 year, 67.6% at 3 years, and 51.5% at 5 years. No patient ≥75 experienced any grade 4 or 5 toxicity.ConclusionsSABR's effectiveness is the same in the elderly as it is in the average age population based on lung cancer-specific survival and time-to-progression. It also poses no increased toxicity. Compared to historical outcomes with surgery in the elderly, SABR outcomes here are considered comparable for stage I-II disease but have less morbidity.



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