Ajay P Sandhu1, Steven K M Lau2, Douglas Rahn2, Sameer K Nath2, Daniel Kim2, William Y Song2, Sachin Gulaya2, Mark M Fuster3, Lyudmila Bazhenova4, Arno J Mundt2. 1. Department of Radiation Medicine and Applied Sciences, Moores University of California San Diego Cancer Center, La Jolla, CA. Electronic address: apsandhu@ucsd.edu. 2. Department of Radiation Medicine and Applied Sciences, Moores University of California San Diego Cancer Center, La Jolla, CA. 3. Division of Pulmonary and Critical Care Medicine, VA San Diego Healthcare System and Department of Medicine, University of California San Diego, La Jolla, CA. 4. Division of Hematology and Oncology, Department of Medicine, University of California San Diego, La Jolla, CA.
Abstract
BACKGROUND: The purpose of this study was to describe our clinical experience using stereotactic body radiation therapy (SBRT) to treat medically inoperable stage I non-small-cell lung cancer (NSCLC) in very elderly patients. PATIENTS AND METHODS: Twenty-four consecutive octogenarians with stage I NSCLC were treated with SBRT between 2007 and 2011 at a single center. Median prescription dose was 48 Gy (range, 48-56). Follow-up clinical examination and computed tomography (CT) were performed every 2 to 3 months. RESULTS: Median age was 85 years (range, 80-89). Twenty-three (96%) patients had peripheral tumors, and median tumor size was 22 mm (range, 11-49). Tissue diagnosis was obtained in 16 (67%) patients. Median follow-up for all patients was 27.6 months (range, 4.3-61.2). The 24-month disease-free survival was 77% (95% confidence interval [CI], 61%-97%). The 24-month overall survival (OS) was 74% (95% CI, 57%-94%). No local failure (LF) was observed during the period of observation. Nodal failure (NF) and distant failure (DF) occurred in 2 and 4 patients, respectively. The cumulative incidence of competing mortality at 24 months was estimated at 13% (95% CI, 3%-30%). No difference in outcomes with or without tissue diagnosis was observed. No grade ≥ 3 early or late treatment-related toxicities were observed. CONCLUSION: Octogenarians tolerate SBRT well, which makes it an attractive treatment option.
BACKGROUND: The purpose of this study was to describe our clinical experience using stereotactic body radiation therapy (SBRT) to treat medically inoperable stage I non-small-cell lung cancer (NSCLC) in very elderly patients. PATIENTS AND METHODS: Twenty-four consecutive octogenarians with stage I NSCLC were treated with SBRT between 2007 and 2011 at a single center. Median prescription dose was 48 Gy (range, 48-56). Follow-up clinical examination and computed tomography (CT) were performed every 2 to 3 months. RESULTS: Median age was 85 years (range, 80-89). Twenty-three (96%) patients had peripheral tumors, and median tumor size was 22 mm (range, 11-49). Tissue diagnosis was obtained in 16 (67%) patients. Median follow-up for all patients was 27.6 months (range, 4.3-61.2). The 24-month disease-free survival was 77% (95% confidence interval [CI], 61%-97%). The 24-month overall survival (OS) was 74% (95% CI, 57%-94%). No local failure (LF) was observed during the period of observation. Nodal failure (NF) and distant failure (DF) occurred in 2 and 4 patients, respectively. The cumulative incidence of competing mortality at 24 months was estimated at 13% (95% CI, 3%-30%). No difference in outcomes with or without tissue diagnosis was observed. No grade ≥ 3 early or late treatment-related toxicities were observed. CONCLUSION: Octogenarians tolerate SBRT well, which makes it an attractive treatment option.
Authors: Han Liu; Benjamin Sintay; Keith Pearman; Qingyang Shang; Lane Hayes; Jacqueline Maurer; Caroline Vanderstraeten; David Wiant Journal: J Appl Clin Med Phys Date: 2018-05-20 Impact factor: 2.102
Authors: Lana C Critchfield; Mark E Bernard; Marcus E Randall; Ronald C McGarry; Damodar Pokhrel Journal: J Appl Clin Med Phys Date: 2020-12-20 Impact factor: 2.102