Should elderly patients with NSCLC be treated with less aggressive radiation therapy?

This trial examined whether aggressive radiation would cause severe side effects in patients over 80 years old with early stage non-small-cell lung cancer (NSCLC). The authors concluded that SBRT is safe and tolerable for older patients.

Stereotactic body radiation therapy (SBRT) is a type of radiation that delivers targeted high-dose radiation to a tumor with fewer treatments. It is currently the standard of care for patients with early stage NSCLC who are unable to have surgery. The treatment commonly has side effects. These include fatigue, chest wall pain, lung inflammation and skin inflammation. These side effects are rarely severe.

Although the treatment is effective, some practitioners are cautious about using aggressive treatment on elderly patients due to the risk of side effects. It remains to be seen whether aggressive SBRT would be more toxic to elderly patients.

This trial aimed to determine whether aggressive SBRT caused severe side effects in patients with early stage NSCLC who are over 80 years old. 31 patients were included.

Average overall survival (time from beginning trial until death) was 29.1 months. Average progression free survival (time from beginning trial until disease progression) was 25.5 months.

There were no side effects worse than grade 1. Grade 1 side effects included fatigue in 16.7% of patients, shortness of breath in 6.7% of patients and lung inflammation with no symptoms in 40% of patients.

The authors concluded that SBRT for elderly patients above 80 years old is safe, tolerable and effective.