Stereotactic ablative body radiation therapy for octogenarians with non-small cell lung cancer

Atsuya Takeda, Naoko Sanuki, Takahisa Eriguchi, Takeshi Kaneko, Satoshi Morita, Hiroshi Handa, Yousuke Aoki, Yohei Oku, Etsuo Kunieda

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Abstract

Purpose: To retrospectively investigate treatment outcomes of stereotactic ablative body radiation therapy (SABR) for octogenarians with non-small cell lung cancer (NSCLC). Methods and Materials: Between 2005 and 2012, 109 patients aged ≥80 years with T1-2N0M0 NSCLC were treated with SABR: 47 patients had histology-unproven lung cancer; 62 patients had pathologically proven NSCLC. The prescribed doses were either 50 Gy/5 fractions for peripheral tumors or 40 Gy/5 fractions for centrally located tumors. The treatment outcomes, toxicities, and the correlating factors for overall survival (OS) were evaluated. Results: The median follow-up duration after SABR was 24.2 (range, 3.0-64.6) months. Only limited toxicities were observed, except for 1 grade 5 radiation pneumonitis. The 3-year local, regional, and distant metastasis-free survival rates were 82.3%, 90.1%, and 76.8%, respectively. The OS and lung cancer-specific survival rates were 53.7% and 70.8%, respectively. Multivariate analysis revealed that medically inoperable, low body mass index, high T stage, and high C-reactive protein were the predictors for short OS. The OS for the operable octogenarians was significantly better than that for inoperable (P<.01). Conclusions: Stereotactic ablative body radiation therapy for octogenarians was feasible, with excellent OS. Multivariate analysis revealed that operability was one of the predictors for OS. For medically operable octogenarians with early-stage NSCLC, SABR should be prospectively compared with resection.

Original languageEnglish
Pages (from-to)257-263
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume86
Issue number2
DOIs
Publication statusPublished - 2013 Jun 1

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ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Takeda, A., Sanuki, N., Eriguchi, T., Kaneko, T., Morita, S., Handa, H., Aoki, Y., Oku, Y., & Kunieda, E. (2013). Stereotactic ablative body radiation therapy for octogenarians with non-small cell lung cancer. International Journal of Radiation Oncology Biology Physics, 86(2), 257-263. https://doi.org/10.1016/j.ijrobp.2013.01.006