Significance of stereotactic body radiotherapy in older patients with early stage non-small cell lung cancer

Objectives: Our aim was to investigate long-term treatment outcomes in older patients with early stage non-small cell lung cancer (NSCLC) and the presence or absence of therapeutic benefits, using the G8 screening tool. Methods: We retrospectively studied 43 older patients (median age 78 years, range 65-89 years) with stage I lung tumors (TI and T2 tumors in 34 and 9 patients, respectively), who underwent stereotactic body radiotherapy (SBRT). This study assessed outcomes in a cohort of patients who received geriatric assessments, performed between 2004 and 2011, before the start of their SBRT regimen. Any questions asked to patients before undergoing treatment were applied to the G8 screening tool. Results: G8 scores ranged from 8 to 16 (median, 12) in all patients (n = 43), while G8 scores in the T1 and T2 groups ranged from 9 to 16 (median, 13) and 8 to 15 (median, 12), respectively. In patients with G8 scores <= 12 the 2-year and 5-year survival rates were 56.1% and 28% respectively, while the rates were 94.1% and 68.4%, respectively, in patients with G8 scores >= 13 (P = 0.0014). During long-term follow-up, 25.9% of the patients (n = 43) died of the primary disease, NSCLC, and 34.9% of patients died of other diseases or other types of cancer. Conclusion: SBRT may be effective, even in older adults. Regardless of age, SBRT improved the long-term survival of patients only with G8 scores >= 13. The G8 screening tool may aid in determining whether older patients with comorbidities would benefit from SBRT. (C) 2018 Elsevier Ltd. All rights reserved.