title: Comparison of the outcomes of stereotactic body radiotherapy and surgery in elderly patients with cT1-2N0M0 non-small cell lung cancer.
abstract: BACKGROUND
  This study aimed to compare the outcomes of stereotactic body radiotherapy (SBRT) and surgery in elderly patients with cT1-2N0M0 non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Elderly patients (≥75 years) with cT1-2 (≤5 cm) N0M0 NSCLC who were treated with SBRT (n=35) or surgery (n=183) between January 2001 and December 2011 were analyzed.
  
  
  RESULTS
  The following radiation doses were administered: 48 Gy/4-6 fractions in 12 patients; 50 Gy/4-5 fractions in 20; and 60 Gy/8 fractions in 3. The following surgical methods were performed: pneumonectomy in 2 patients, lobectomy in 154, segmentectomy in 23, and wedge resection in 4. Patients in the SBRT group had a higher mean age, a worse performance status, and a lower percentage of forced expiratory volume in 1.0 s than those in the surgery group. The overall 5-year survival rates were 43.8% and 67.6% for the SBRT and surgery groups, respectively (p=0.057, log-rank test). Regarding tumor diameter, patients in the surgery group survived significantly longer than did those in the SBRT group (>20-mm tumors, p=0.027; >30-mm tumors p=0.043), whereas survival did not differ significantly between the groups for ≤20-mm tumors (p=0.982). Multivariate analysis confirmed the improved survival in the surgery group compared to the SBRT group for all tumors (p=0.034) and for >20-mm tumors (p=0.016).
  
  
  CONCLUSIONS
  Post-therapeutic survival among elderly patients might be better with surgery than with SBRT in NSCLC patients with tumors >20 mm.
authors.affiliation: Department of Thoracic Surgery, Tenri Hospital, 200, Mishima, Tenri, Nara 632-8552, Japan. Electronic address: t-nakaga@tenriyorozu.jp.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Nakagawa
authors.affiliation: Department of Radiology, Tenri Hospital, 200, Mishima, Tenri, Nara 632-8552, Japan. Electronic address: y-negoro@tenriyorozu.jp.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Negoro
authors.affiliation: Department of Thoracic Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan. Electronic address: tm8191@kchnet.or.jp.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Matsuoka
authors.affiliation: Department of Thoracic Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan. Electronic address: no7869@kchnet.or.jp.
authors.forename: Norihito
authors.initials: N
authors.lastname: Okumura
authors.affiliation: Department of Radiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan. Electronic address: yd6472@kchnet.or.jp.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Dodo
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods*; D016634:Radiosurgery / Q000379:methods*; D011879:Radiotherapy Dosage; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Elderly patients; Lung cancer; Stereotactic body radiotherapy; Surgery