Hypofractionated radical radiotherapy in elderly patients with medically inoperable stage I–II non-small-cell lung cancer

Hypofractionated three-dimensional conformal radiotherapy for medically inoperable early stage non-small-cell lung cancer

“…A 2-year OS of 54.3%, 2-year PFS of 61.1%, 2-year LC of 74.6%, and 2-year LRFS of 61.9% were achieved; this outcome was comparable with results from previous HFRT reports (2-year OS of 50-60%, 2-year LC of 63-76%), but PFS was superior to those reported in previous studies (2-year PFS of 38-40%) [10-14]. Local failure was the predominant pattern, as in previous studies of radical radiotherapy in early stage NSCLC [3,11,17].…”

“…Hypofractionated radiotherapy (HFRT) using 3D-CRT can be considered as the second policy in clinics and patients ineligible for SABR. Some studies of HFRT using various radiation dose schedules resulted in improved outcomes beyond those achieved with conventionally fractionated radiotherapy [10-14]. Thus, the purpose of the present study was to assess the clinical outcomes of HFRT for medically inoperable patients with early stage NSCLC and to evaluate prognostic factors.…”

Lung Cancer in Elderly

“…Another study presenting results about toxicity in 51 patients older than 65 years shows no augmentation of the toxicity in these patients in function with age, but survival was significantly correlated with performance status and importance of comorbidities (Fiorica et al, 2010). Retrospective case series of older patients treated with curative radiation alone have demonstrated a median survival of up to 37 months for stage I-II and 8 months pour stage III (Bonfili et al, 2009;Lonardi et al, 2000;San José et al, 2006& Tombolini et al, 2000. It is recommended to provide elderly patients with advanced lung cancer disease in good general condition radiotherapy combined with chemotherapy.…”

Radiotherapy for lung cancer in the elderly

“…n Stage Median age (range) Radiotherapy dose/fractionation Survival Gd 3+ acute oesophagitis/pneumonitis Gauden and Tripcony [18] 162 I 50 Gy (2.5 Gy per fraction) minimum tumour dose 34% at 5 years Not recorded Furuta et al [15] 32 I-II 79 (75)(76)(77)(78)(79)(80)(81)(82)(83)(84)(85)(86) >60 Gy (2.0 Gy per fraction) 40% at 2 years 0 Bonfili et al [14] 36 I-II 77 60 Gy (3.0 Gy per fraction) 55.6% at 2 years 0 San Jose et al [12] 33 I-II 75 Median 70 Gy (2.0 Gy per fraction) 50% at 3 years 6% Yu et al [27] 80 I-II 76 (70)(71)(72)(73)(74)(75)(76)(77)(78)(79)(80)(81)(82)(83)(84) 66.6 Gy (1.8 Gy per fraction) 55.7% at 2 years 5.1% Pergolizzi et al [26] 40 IIIa 77 (75)(76)(77)(78)(79)(80)(81)(82)(83) Median 60 Gy (2.0 Gy per fraction) 18% at 3 years 5% Lonardi et al [11...…”

“…Retrospective case series of elderly patients receiving radical external beam radiotherapy (EBRT) alone for NSCLC have demonstrated a median survival of up to 37 months for stage I-II disease and 8 months for stage III disease [11][12][13][14][15]. Several retrospective series have compared outcomes for elderly and younger patients with NSCLC treated with EBRT and shown that age is not a negative prognostic factor [16][17][18][19][20][21].…”