title: Stereotactic body radiation therapy in octogenarians with stage I lung cancer.
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.
  
  
  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.
  
  
  CONCLUSIONS
  Octogenarians tolerate SBRT well, which makes it an attractive treatment option.
authors.affiliation: Department of Radiation Medicine and Applied Sciences, Moores University of California San Diego Cancer Center, La Jolla, CA. Electronic address: apsandhu@ucsd.edu.
authors.forename: Ajay P
authors.initials: AP
authors.lastname: Sandhu
authors.affiliation: Department of Radiation Medicine and Applied Sciences, Moores University of California San Diego Cancer Center, La Jolla, CA.
authors.forename: Steven K M
authors.initials: SK
authors.lastname: Lau
authors.affiliation: Department of Radiation Medicine and Applied Sciences, Moores University of California San Diego Cancer Center, La Jolla, CA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Rahn
authors.affiliation: Department of Radiation Medicine and Applied Sciences, Moores University of California San Diego Cancer Center, La Jolla, CA.
authors.forename: Sameer K
authors.initials: SK
authors.lastname: Nath
authors.affiliation: Department of Radiation Medicine and Applied Sciences, Moores University of California San Diego Cancer Center, La Jolla, CA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kim
authors.affiliation: Department of Radiation Medicine and Applied Sciences, Moores University of California San Diego Cancer Center, La Jolla, CA.
authors.forename: William Y
authors.initials: WY
authors.lastname: Song
authors.affiliation: Department of Radiation Medicine and Applied Sciences, Moores University of California San Diego Cancer Center, La Jolla, CA.
authors.forename: Sachin
authors.initials: S
authors.lastname: Gulaya
authors.affiliation: Division of Pulmonary and Critical Care Medicine, VA San Diego Healthcare System and Department of Medicine, University of California San Diego, La Jolla, CA.
authors.forename: Mark M
authors.initials: MM
authors.lastname: Fuster
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, University of California San Diego, La Jolla, CA.
authors.forename: Lyudmila
authors.initials: L
authors.lastname: Bazhenova
authors.affiliation: Department of Radiation Medicine and Applied Sciences, Moores University of California San Diego Cancer Center, La Jolla, CA.
authors.forename: Arno J
authors.initials: AJ
authors.lastname: Mundt
mesh_terms: D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D016634:Radiosurgery; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Elderly; Non–small-cell lung cancer; Stereotactic body radiation therapy