Stereotactic body radiotherapy for elderly patients with NSCLC

The authors aimed to determine whether SBRT is an effective and tolerable treatment for elderly patients with inoperable non-small cell lung cancer (NSCLC). They concluded that the treatment is both effective and safe.

In elderly patients with NSCLC, surgery is not always the best option. There is often a higher rate of comorbidities (other diseases) in elderly patients. Comorbidities can result in post-surgical complications that lead to reduced rate of patient survival.

Stereotactic body radiotherapy (SBRT) is a cancer treatment which involves high dose radiation targeted to specific tumors. SBRT has been shown to result in high survival rates in patients who are ineligible for surgery. Whether SBRT or surgery is a better option for elderly patients with NSCLC remains to be seen.

This review aimed to determine whether there is a link between higher rates of comorbidities and surgery effectiveness and tolerability. They also aimed to determine whether SBRT was effective and safe for elderly patients with NSCLC.

The authors combined data from 43 studies for the review. Most studies reported the Charlson score, which is a measure of comorbidities and their severity. Charlson scores increased with age. In those under 60, 8% of patients had higher Charlson scores. For patients aged between 60 and 69, 26% had higher scores. 43% of patients aged between 70 and 79 had higher scores. The increase in Charlson score was related to an increase in the amount of comorbidities per patient.

For patients aged over 70 who underwent surgery, there was a post surgical mortality rate (measure of number of deaths) ranging between 1.1% and 22% and complications rate ranging between 7.4% and 55.2%. The 5-year survival rates ranged between 20% and 57%.

For patients aged over 75, the 3-year post-surgical mortality rate was 2.3% and the complication rate was 18.6%. The 3-year survival rate was 65%.

For patients over 80, the post-surgical mortality rate ranged between 1.2% and 12%. The complications rate ranged between 8.4% and 50%. The 5-year survival rates ranged between 19.1% and 65.9%.

Patients who underwent SBRT had mortality rates ranging between 0 and 1.7% and complications rates ranging between 0.9% and 10%. 3-year survival rates ranged between 40.7% and 53%.

The authors concluded that SBRT is an effective and tolerable treatment for elderly patients with inoperable NSCLC.