title: Management of single malignant lung nodules in elderly patients (70 years or older) who are not candidates for lobectomy.
abstract: OBJECTIVE
  The aim of this study was to evaluate and compare sublobar resection plus intraoperative seed implant (IOS) versus stereotactic body radiation therapy (SBRT) in patients with single malignant lung nodules in patients 70 years of age or older.
  
  
  METHODS
  A retrospective chart review was performed and 47 patients with adequate information were selected for analysis. Thirty patients with single malignant lung nodules received SBRT. Seventeen patients received limited surgical resection plus radioactive seed implantation for solitary malignant lung nodules. Univariate statistical analysis showed a significant difference only for the age in the 2 groups: the mean age in the radioactive seed group, 78.8 years versus 76.1 years in the SBRT group (2-sided, P=0.05).
  
  
  RESULTS
  There was high local control and minimal toxicity with either treatment modality and no significant difference among the 2 groups in terms of local control, survival, and toxicity. However, the distant failure was higher but not statistically significant in the SBRT group (9 of 30 patients in SBRT vs. 0 of 17 in IOS, P=0.1).
  
  
  CONCLUSIONS
  Our study has shown excellent outcomes and limited toxicity in both IOS and SBRT for treatment of single malignant lung nodules in patients who are not candidates for lobectomy. However, a randomized trial is needed in this group of elderly patients to determine the most appropriate treatment.
authors.affiliation: Stich Radiation Center, Weill Cornell Medical Center, New York, NY 10021, USA. bup9001@med.cornell.edu
authors.forename: Bhupesh
authors.initials: B
authors.lastname: Parashar
authors.forename: Priti
authors.initials: P
authors.lastname: Patel
authors.forename: Prabhsimranjot
authors.initials: P
authors.lastname: Singh
authors.forename: Stefano
authors.initials: S
authors.lastname: Monni
authors.forename: Samuel
authors.initials: S
authors.lastname: Trichter
authors.forename: Albert
authors.initials: A
authors.lastname: Sabbas
authors.forename: A Gabriella
authors.initials: AG
authors.lastname: Wernicke
authors.forename: Dattatreyudu
authors.initials: D
authors.lastname: Nori
authors.forename: K S Clifford
authors.initials: KS
authors.lastname: Chao
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D008297:Male; D019736:Prostheses and Implants; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes