MRI-guided stereotactic body radiation therapy for very elderly patients with primary lung cancer: a retrospective analysis of safety and efficacy profiles
Abstract
Non-small cell lung cancer is the most common malignancy of the lung, with over 40% of the cases in patients aged 75 years or older. Many of these patients are inoperable due to comorbidities, limiting treatment options. Stereotactic body radiotherapy (SBRT) offers a curative alternative, achieving local control (LC) rates similar to surgery with manageable toxicity. This retrospective analysis aimed to investigate the efficacy and safety of MRI-guided SBRT (MRIgSBRT) for elderly lung cancer patients. Data of patients aged ≥ 75 years, treated in our Institution between 2017 and 2023, were retrospectively collected. Survival curves for local recurrence-free survival (LRFS), progression-free survival and overall survival (OS) were estimated using the Kaplan–Meier method. Toxicity was assessed using the Common Terminology Criteria for Adverse Events (CTCAE version 5.0) scale. The study included 38 patients with a total of 45 lung lesions, median age of 82 years (range 75–87). The median total radiotherapy dose was 62,5 Gy (range 24–75 Gy) delivered in 5 fractions (range 3–8). The median follow-up was of 16.9 months (range 0,97–66,7). The 1-, 2- and 3-year OS rates were 98% 96% and 80%, respectively, while the 1-, 2- and 3-year LRFS was 97,5%. Six patients (15.78%) and one patient (2.63%) had late G1 radiation-induced pneumonia and G2 dyspnoea, respectively. MRIgSBRT is a valid therapeutic option for patients aged ≥ 75 with comorbidities, frailty and risk factors limiting their…
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