Stereotactic body radiotherapy using real-time tumor tracking in octogenarians with non-small cell lung cancer.
As the incidence of stage I non-small cell lung cancer (NSCLC) increases among octogenarians and only selected patients are surgical candidates, an alternative treatment is necessary. This manuscript evaluates the overall survival, local tumor control rate, and treatment-related toxicity after stereotactic body radiotherapy (SBRT) in 38 octogenarians with stage I NSCLC. Treatment consisted of 45Gy (n=4) or 60Gy (n=25) in 3 fractions for patients with peripheral tumors. A risk adaptive schedule of 45-60Gy in 3-6 fractions was used for central (n=7) or large peripheral tumors (n=2). An overall survival rate of 65% at 1 year and 44% at 2 years was achieved in octogenarians after SBRT. The local tumor control rate was excellent (100% at 2 years) and no grade 4 or 5 treatment-related toxicity occurred. Despite the high incidence of comorbidity in these octogenarians (Charlson score >or=5 in 16% of patients), an approach that merely provides supportive care cannot always be justified. SBRT offers octogenarians with stage I NSCLC a good treatment alternative.
van der Voort van Zyp
Noëlle C
NC
Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Groene Hilledijk 301, 3075 EA Rotterdam, The Netherlands. n.vandervoortvanzyp@erasmusmc.nl
van der Holt
Bronno
B
van Klaveren
Robertus J
RJ
Pattynama
Peter
P
Maat
Alexander
A
Nuyttens
Joost J
JJ
D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy*; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy*; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D011446:Prospective Studies; D016019:Survival Analysis