Stereotactic body radiotherapy in patients with stage i non-small-cell lung cancer aged 75 years and older: Retrospective results from a multicenter consortium

Michael A. Samuels, Shravan Kandula, Tulay Koru-Sengul, Jeffrey A. Bogart, Joseph K. Salama, Paul D. Aridgides, Ajeet Gajra, Rogerio C. Lilenbaum

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Background: This study was a retrospective analysis of elderly patients treated with stereotactic body radiotherapy (SBRT) in the setting of a multi-institutional consortium. Patients and Methods: Three institutions pooled data on patients aged ≥ 75 years who received SBRT for stage I non-small-cell lung cancer (NSCLC). Forty-seven tumors in 46 patients were analyzed in patients aged 75 to 92 years (median, 82 years). Treatment was delivered during 2007 to 2009, with a median follow-up of 12.4 months. All patients underwent staging positron emission tomography-computed tomography (PET-CT), and 87% of tumors were confirmed by biopsy results. Total doses were 35 to 60 Gy, mainly in 3 to 5 fractions. All tumors were treated using a linear accelerator, with 96% of patients receiving 3-dimensional (3D) conformal RT and 4% undergoing intensity modulated RT (IMRT). Results: At the time of analysis, the local failure rate was 2% (1 of 47). The regional failure rate was 9% (4 of 47). The distant failure rate was 6% (3 of 47). The combined failure rate was 15% (7 of 47) because 1 patient experienced both regional and distant failure. Among 20 tumors with any acute toxicity, there were no ≥ grade 3 toxicities. Pneumonitis (n = 10) grades 1 (n = 3) and 2 (n = 2) was seen in 15% and 10% of patients, respectively; these data were missing for 25% of patients. Conclusion: SBRT in patients aged ≥ 75 years with stage I NSCLC proved tolerable, with toxicity rates comparable to those in younger patients. Excellent rates of local, regional, and distant control were achieved at a median follow-up of 12.4 months. This patient population represents a rapidly growing segment of the early lung cancer population, and SBRT appears to be a safe and effective treatment option for patients who are not optimal candidates for surgery.

Original languageEnglish (US)
Pages (from-to)446-451
Number of pages6
JournalClinical Lung Cancer
Volume14
Issue number4
DOIs
StatePublished - Jul 2013

Keywords

  • Elderly
  • Inoperable
  • Pneumonitis
  • Radiation
  • Safety

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pulmonary and Respiratory Medicine

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