Stereotactic Ablative Radiotherapy is a Highly Safe and Effective Treatment for Elderly Patients with Early Stage Non-Small Cell Lung Cancer
Menée à partir de données portant sur 772 patients atteints d'un cancer du poumon non à petites cellules de stade T1-T3 N0M0 traité entre 2004 et 2014, cette étude évalue, en fonction de deux catégories d'âge (inférieur à 75 ans, supérieur ou égal à 75 ans), l'efficacité, du point de vue du délai avant progression de la maladie, de la survie spécifique et de la survie globale, et la toxicité d'une radiothérapie stéréotaxique ablative
Purpose : To discern the efficacy and toxicity of SABR in the elderly population (age ≥75), and to consider how it compares to surgical outcomes historically reported in the elderly. Methods and Materials : 772 patients with clinically early-stage I-II NSCLC (T1-T3 N0M0) were treated with SABR (50 Gy in 4 fractions or 70 Gy in 10 fractions) between 2004-2014 at our center (n=442 age <75, n=330 age ≥75). Primary end points included overall survival, time-to-progression, and grade ≥3 toxicity. Median follow-up time was approximately 55 months. Results : Compared to patients age <75, patients age ≥75 had no difference in time-to-progression (p=0.419), lung cancer-specific survival (p=0.275), or toxicity (p=0.536). Overall survival was the same between both age groups at 2-years of follow-up but diverged thereafter, with patients aged <75 when treatment began having higher overall survival rates at 5 years. Median OS rates for patients age ≥75 were 86% at 1 year, 57.5% at 3 years, and 39.5% at 5 years. Median OS rates for patients age <75 were 87.3% at 1 year, 67.6% at 3 years, and 51.5% at 5 years. No patient ≥75 experienced any grade 4 or 5 toxicity. Conclusions : SABR’s effectiveness is the same in the elderly as it is in the average age population based on lung cancer-specific survival and time-to-progression. It also poses no increased toxicity. Compared to historical outcomes with surgery in the elderly, SABR outcomes here are considered comparable for stage I-II disease but have less morbidity.