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Purpose <p>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.</p> Materials and methods <p>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.</p> Results <p>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.</p> Conclusions <p>MRIgSBRT is a valid therapeutic option for patients aged ≥ 75 with comorbidities, frailty and risk factors limiting their performance status and eligibility for invasive treatments, offering good LC and favourable toxicity profile.</p>

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MRI-guided stereotactic body radiation therapy for very elderly patients with primary lung cancer: a retrospective analysis of safety and efficacy profiles

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月22日

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  • Luca Boldrini,
  • Angela Romano,
  • Ilaria Castanò,
  • Antonella Martino,
  • Filippo Lococo,
  • Giuseppe Cicchetti,
  • Matteo Nardini,
  • Giulia Panza,
  • Lorenzo Placidi,
  • Giuditta Chiloiro

摘要

Purpose

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.

Materials and methods

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.

Results

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.

Conclusions

MRIgSBRT is a valid therapeutic option for patients aged ≥ 75 with comorbidities, frailty and risk factors limiting their performance status and eligibility for invasive treatments, offering good LC and favourable toxicity profile.