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J Geriatr Oncol. 2018 Nov 10. pii: S1879-4068(18)30288-1. doi: 10.1016/j.jgo.2018.10.011. [Epub ahead of print]

Treatment completion, treatment compliance and outcomes of old and very old patients treated by dose adapted stereotactic ablative radiotherapy (SABR) for T1-T3N0M0 non-small cell lung cancer.

Author information

1
Beacon Hospital, Dept of Radiotherapy, Dublin, Ireland. Electronic address: alina.mihai@alumni.utoronto.ca.
2
University of Rochester School of Medicine and Dentistry, Dept of Radiation Oncology, Rochester, New York, USA.
3
Beacon Hospital, Dept of Medical Oncology, Dublin, Ireland.
4
Beacon Hospital, Dept of Radiotherapy, Dublin, Ireland.

Abstract

AIM:

This is a retrospective single-institution review of the treatment completion and clinical outcomes of patients aged 75 and older, treated with stereotactic ablative body radiotherapy (SABR) for T1-T3 N0 M0 non-small cell lung cancer (NSCLC).

MATERIAL:

METHODS:

From April 2008 to September 2015, 200 patients, aged 75-93, received respiratory-managed, intensity-modulated-based SABR. Dose fractionation was risk-adapted and delivered in 2-3 weekly treatments. Treatment completion, local control, overall survival and treatment-related toxicities were evaluated.

RESULTS:

All patients completed the prescribed SABR course. However, 29 patients required interruption of at least one fraction of SABR and optimization of pain control before continuation of the fraction. Median follow-up was 20.9 months. The median OS was 31.6 months with 1-,3-year survival rates of 80.7%, and 44.4% respectively. Local control at 1- and 3- years were 97.6%, 83.5% respectively. Treatment was well-tolerated. However, there were two (1%) G5 (fatal) toxicities: one acute sudden dyspnoea of unknown cause and one late SABR-related haemoptysis. No statistically significant differences in outcomes/toxicities were observed between old (75-84 years old) and very old patients (>85 years old).

CONCLUSIONS:

Old and very old patients can successfully complete SABR for NSCLC, with good local control, survival and acceptable toxicity. Old patients might require increased supportive care for successful treatment delivery.

KEYWORDS:

Lung SABR/SBRT; Old/very old patients treatment completion; Toxicity

PMID:
30420322
DOI:
10.1016/j.jgo.2018.10.011

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