title: Stereotactic ablative body radiation therapy for octogenarians with non-small cell lung cancer.
abstract: OBJECTIVE
  To retrospectively investigate treatment outcomes of stereotactic ablative body radiation therapy (SABR) for octogenarians with non-small cell lung cancer (NSCLC).
  
  
  METHODS
  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.
authors.affiliation: Radiation Oncology Center, Ofuna Chuo Hospital, Kanagawa, Japan.
authors.forename: Atsuya
authors.initials: A
authors.lastname: Takeda
authors.forename: Naoko
authors.initials: N
authors.lastname: Sanuki
authors.forename: Takahisa
authors.initials: T
authors.lastname: Eriguchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kaneko
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Handa
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Aoki
authors.forename: Yohei
authors.initials: Y
authors.lastname: Oku
authors.forename: Etsuo
authors.initials: E
authors.lastname: Kunieda
mesh_terms: D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D019583:Dose Fractionation, Radiation; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D015999:Multivariate Analysis; D009363:Neoplasm Proteins / Q000378:metabolism; D009367:Neoplasm Staging; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D009363:Neoplasm Proteins; D002097:C-Reactive Protein