The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou, 215123, China.
J Cancer Res Clin Oncol. 2020 May;146(5):1263-1271. doi: 10.1007/s00432-020-03154-5. Epub 2020 Feb 24.
Stereotactic body radiotherapy (SBRT) is the primary treatment method for early-stage non-small cell lung cancer (NSCLC) considered inoperable due to medical comorbidities. However, the application of SBRT in patients aged ≥ 75 years has not been adequately studied. This retrospective study aimed to investigate the effectiveness and safety of SBRT in early-stage NSCLC patients aged ≥ 75 years, and the impact of treatment on nutritional status and self-care ability.
Histopathologically confirmed early-stage (T1-3N0M0) NSCLC patients aged ≥ 75 years treated with SBRT between 2013 and 2018 at our center were identified from the electronic database. Treatment efficacy, treatment toxicities, impact of treatment on nutritional status, and self-care ability were retrospectively analyzed. Toxicities were evaluated according to the Common Terminology Criteria for Adverse Event (CTCAE) (Common 2010) version 4.0. Nutritional status was assessed by Nutritional Risk Screening 2002 criteria, and self-care ability by Barthel index and fall risk index.
A total of 68 patients were enrolled. Median follow-up duration was 46.3 (3.9-80.1) months. The 1-, 3-, and 5-year overall survival rates were 92.6%, 77.2%, and 59.1%, respectively, and the 1-year, 3-year and 5-year local control rates were 95.6%, 88.9% and 85.6%, respectively. Grade 1-2 and grade 3 radiation pneumonitis occurred in 60/68 (96.8%) and 1/68 (1.5%) patients, respectively. Fall risk at 3 months after treatment was not significantly different from that before treatment (P = 0.22). Barthel index increased significantly after treatment (P < 0.001).
SBRT appears to be effective and safe for NSCLC patients aged ≥ 75 years, with no adverse impact on nutritional status and self-care ability.
立体定向体部放疗（SBRT）是因合并症而无法手术的早期非小细胞肺癌（NSCLC）的主要治疗方法。然而，SBRT 在年龄≥75 岁的患者中的应用尚未得到充分研究。本回顾性研究旨在探讨 SBRT 在年龄≥75 岁的早期 NSCLC 患者中的有效性和安全性，以及治疗对营养状况和自理能力的影响。
从电子数据库中确定了 2013 年至 2018 年在我们中心接受 SBRT 治疗的组织病理学确诊的年龄≥75 岁的早期（T1-3N0M0）NSCLC 患者。回顾性分析了治疗效果、治疗毒性、治疗对营养状况和自理能力的影响。毒性根据不良事件通用术语标准（CTCAE）（通用 2010 版）4.0 版进行评估。营养状况采用营养风险筛查 2002 标准评估，自理能力采用 Barthel 指数和跌倒风险指数评估。
共纳入 68 例患者。中位随访时间为 46.3（3.9-80.1）个月。1、3 和 5 年总生存率分别为 92.6%、77.2%和 59.1%，1、3 和 5 年局部控制率分别为 95.6%、88.9%和 85.6%。68 例患者中，60 例（96.8%）发生 1-2 级和 1 例（1.5%）发生 3 级放射性肺炎。治疗后 3 个月的跌倒风险与治疗前无显著差异（P=0.22）。治疗后 Barthel 指数显著增加（P<0.001）。
SBRT 似乎对年龄≥75 岁的 NSCLC 患者有效且安全，对营养状况和自理能力无不良影响。
