Stereotactic Body Radiotherapy for Early-Stage Non-Small Cell Lung Cancer in Patients Aged 80 Years and Older: A Single-Center Retrospective Cohort Study of Octogenarians and Nonagenarians.

[BACKGROUND] As the global population continues to age, the management of early stage non-small cell lung cancer (NSCLC) in patients aged ≥ 80 years has become increasingly relevant. Stereotactic body radiotherapy (SBRT) is a noninvasive alternative; however, evidence regarding its safety and efficacy in octogenarians and nonagenarians remains limited.

[METHODS] Data of 205 consecutive patients aged ≥ 80 years (median age, 84 years; range, 80-93 years) with early stage NSCLC (clinical T1-2bN0M0, AJCC 8th edition) treated with SBRT between January 2003 and November 2024 were retrospectively analyzed. The patients were stratified into younger (80-85 years) and older (> 85 years) subgroups.

[RESULTS] With a median follow-up of 32.0 months, the median OS was 74.9 months, and the 1- and 3-year OS rates were 93.9% and 70.7%, respectively. The median PFS was 45.2 months, with 1- and 3-year PFS rates of 83.3% and 55.0%, respectively. The 3-year OS was 69.4% in patients aged 80 to 85 years and 73.5% in those > 85 years. Similarly, the 3-year PFS was 51.7% and 62.1% (P = .289). Multivariate analysis revealed that sex, performance status, pathological confirmation, and biologically effective dose were independent predictors of OS and/or PFS, whereas chronological age was not. Grade ≥ 3 treatment-related toxicity was low (4.4%), with 3.4% experiencing grade ≥ 3 pneumonitis and no fatal adverse events.

[CONCLUSION] SBRT proved to be a safe and effective treatment option for early stage NSCLC in patients aged ≥ 80 years, including those aged > 85 years. These findings support the consideration of SBRT in appropriately selected older patients.