SBRT Deemed Safe and Effective in Older Patients With Lung Cancer

Stereotactic body radiation therapy (SBRT) is a safe treatment for patients aged 80 years or older with early-stage lung cancer, according to a recent study published in the International Journal of Radiation Oncology (June 15, 2017;98[4]:893-899).


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Meredith Giuliani, MBBS, Med, FRCPC, radiation oncologist, Princess Margaret Cancer Centre (Toronto, Canada), and colleagues conducted a study to determine the safety and efficacy of lung SBRT in older patients (aged ≥80 years) compared with younger patients. Researchers evaluated a total of 1083 cases of primary lung cancer (mean age, 75 years) treated with SBRT from a multi-institutional database. The researchers compared outcomes among those aged less than 70 years (n = 305), 70 years to 79 years (n = 448), and 80 years or older (n = 330). Median follow-up lasted 1.7 years.

The researchers calculated all events from the end of radiation therapy, as well as estimates of local recurrence, regional recurrence, and distant metastases via the competing risk method. Cause-specific survival (CSS) and overall survival (OS) were calculated. Additionally, univariable and multivariable analyses were conducted to determine associations with CSS and OS in patients aged 80 years or older.

Results of the study indicated no difference between groups in CSS, 2-year local recurrence, regional recurrence, or distant metastases.

Patients aged 80 years or older demonstrated significantly lower 2-year OS. However, this was likely due to other medical issues typically seen in older patients.

The grade 3+ pneumonitis rate was 1.3% in patients under aged 70 years, compared with 1.6% in patients aged 70 to 79 years and 1.5% in patients aged 80 years or older. The 90-day mortality rates were 1.3%, 2.5%, and 2.4%, respectively. OS was associated with T-category in patients ages 80 years or older, the researchers noted.

“Stereotactic body radiation therapy is a safe treatment modality in elderly patients (aged [80 years or older]),” the researchers concluded. “Despite larger tumor volumes, the tumor control outcomes were comparable to those in younger patients treated with SBRT. All patients with early-stage lung cancer, regardless of age, should be considered for treatment with SBRT.”—Christina Vogt