Elderly Patients With Early-stage Lung Cancer Good Candidates For SBRT, Study Suggests

Elderly people with early-stage lung cancer might also benefit from stereotactic body radiation therapy (SBRT), finds a study of more than 1,000 patients.

The study, “Stereotactic Body Radiation Therapy in Octo- and Nonagenarians for the Treatment of Early-Stage Lung Cancer,” appeared in the International Journal of Radiation Oncology • Biology • Physics. It showed that people over 80, who were usually not considered for radiotherapy because of the risks of treatment, are good candidates for this newer form of radiation, and their outcomes are just as good as those of younger patients.

With SBRT, radiation is applied specifically to the tumor, sparing healthy tissue. The specific targeting allows doctors to use high doses of radiation, further improving outcomes.

Researchers looked into patient records in a database that stored information about treatment effectiveness and side effects. Data were collected by centers belonging to the Elekta Lung Research Group.

The studied group consisted of 305 patients younger than 70, 448 patients aged 70 to 79 years, and 330 patients aged 80 years or older — including 16 older than 90. There were even 16 patients older than 90. The study included patients between 41 and 94 years of age.

Researchers compared the recurrence of cancer within a two-year interval, recurrence in the same area, distant metastases, or how often grade 3 or more severe toxicity occurred in the three age groups. They discovered that cause-specific survival was similar in all three groups.

Overall survival, which assesses death by any cause, was lower among older patients, likely reflecting other medical issues older people might have, researchers said.

“Older patients are often not considered for radiation therapy due to concerns about their ability to tolerate treatment. The results of our study clearly support the use of SBRT for elderly patients, especially those who may not be able to tolerate longer courses of radiotherapy or more invasive treatment options,” study leader Meredith Giuliani, a radiation oncologist at Toronto’s Princess Margaret Cancer Centre, said in a press release.

“Radiation oncologists need to work closely with our peers in other parts of the medical community to ensure that patients with diagnosed or suspected early-lung cancer are evaluated for potential treatment with SBRT regardless of age,” said Giuliani.

The Elekta Lung Research Group comprises physicians and physicists who work in an international collaboration to evaluate disease outcomes in early-stage non-small cell lung cancer patients.

“This study is the largest series of its type to evaluate SBRT outcomes in patients aged 80 years and older,” said Dr. Joel Goldwein, senior vice-president of medical affairs for Elekta. “In addition to providing important support for using SBRT to treat early-stage lung cancer in elderly patients, these findings highlight the value of multi-institutional collaborations and large data sets that can provide statistically meaningful answers to critical questions about treatment outcome and guide clinical decision-making.”