title: Stereotactic ablative body radiation therapy for tumors in the lung in octogenarians: a retrospective single institution study.
abstract: BACKGROUND
  Treatment of cancer in the lung in octogenarians is limited by their health and functional status. Stereotactic ablative radiotherapy is an established noninvasive treatment option for medically inoperable patients, with a toxicity profile that may be more tolerable in elderly patients.
  
  
  METHODS
  Patients more than 80 years old treated with stereotactic ablative radiotherapy for malignant tumors in the lung between January 2007 and August 2012 at a single institution were identified and retrospectively analyzed for toxicity and survival.
  
  
  RESULTS
  Thirty patients were identified with a total of 32 lesions treated. Patients ranged in age from 80.8 to 90.7 years old (median 84.9) at the time of treatment. Twenty patients had ECOG performance status 0-1, and 10 had performance status 2-3. Stage distribution at treatment was: stage I (20 patients), stage III (1), stage IV (1), and 8 recurrent tumors. Patients were treated to a median total dose of 54 Gy in 3 fractions (range 20-60 Gy in 1 to 5 fractions). Median follow up was 13 months (range 2-60 months). Fifteen patients were still living at last review. There was one failure in field and one failure in the same lobe that was treated. One patient died with progressive regional disease, and four died of progressive metastatic disease. Three patients had late grade 3 pulmonary dyspnea with no grade 4 or 5 toxicities. One patient had late grade 2 pneumonitis, and 3 patients had late grade 1 pneumonitis. Three patients had grade 1 chest wall pain.
  
  
  CONCLUSIONS
  Octogenarians tolerated ablative treatment with minimal toxicity. Stereotactic ablative body radiotherapy is an option to consider in treatment of elderly patients.
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Cannon
authors.forename: Puneeth
authors.initials: P
authors.lastname: Iyengar
authors.forename: Hak
authors.initials: H
authors.lastname: Choy
authors.forename: Robert
authors.initials: R
authors.lastname: Timmerman
authors.affiliation: Department of Radiation Oncology, University of Texas Southwestern, 5801 Forest Park Rd, Dallas 75390, Texas, USA. Jeffrey.Meyer@utsouthwestern.edu.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Meyer
mesh_terms: D000369:Aged, 80 and over; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D016634:Radiosurgery / Q000009:adverse effects*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome