S L I D E 1

Elderly Patients Undergoing SBRT for Inoperable Early Stage NSCLC Achieve Similar Outcomes to Younger Patients

Brandon R. Mancini, Henry S. Park, Eileen Harder, Charles E. Rutter, Christopher D. Corso, Roy H. Decker, Zain A. Husain

Session title: (DPD 01) Lung 1 - Novel Prognostic Factors and SBRT

Session date: September 14, 2014Abstract number: 1520

S L I D E 2

Background / Methods

• Purpose/Objective(s): To address toxicity and survival achieved with SBRT in the elderly compared to younger patients treated at the same institution.

• Materials/Methods: – Patients diagnosed with T1-3N0M0 NSCLC treated with

SBRT between Sep 2007 and Aug 2013.– SBRT was delivered in 3-5 fractions to 40-60 Gy, with a vast

majority of patients receiving 54 Gy in 3 fractions. – Patients were divided into two cohorts, age >75 and <75. – We compared overall survival (OS) and local recurrence-free

survival (LRFS) between cohorts.

S L I D E 3

Results

Table 1. Patient characteristics.Age

p-value< 75 years old (n=126)

> 75 years old (n=127)

Median Age (years) 68.0 82.6 <0.001Median Follow-up (months) 24.9Gender (%) 1.00

Male 70 (55.6) 70 (55.1)Female 56 (44.4) 57 (44.9)

T-Stage 0.88T1 95 (75.4) 97 (76.4)T2 26 (20.6) 26 (20.5)T3 5 (4.0) 4 (3.1)

ECOG Performance Status (%) 0.67

0 36 (28.6) 36 (28.3)1 56 (44.4) 60 (47.2)2 27 (21.4) 24 (18.9)3 7 (5.6) 7 (5.5)

Histology (%) 0.59Adenocarcinoma 42 (33.3) 42 (33.1)Squamous Cell Carcinoma 23 (18.3) 35 (27.6)Unspecified NSCLC 11 (8.7) 5 (3.9)Unknown 50 (40.0) 45 (35.4)

Mediastinoscopy (%) 0.10Yes 44 (34.9) 32 (25.2)No 82 (65.1) 95 (74.8)

Median BED (Gy) 151.2 151.2 0.32

S L I D E 4

Results

p=0.95

<75 years 126 83 41 15 3 2 0

≥75 years 127 78 30 22 7 1 0

Number at Risk

2-Year OS<75 years: 60.2%≥75 years: 48.9%

Median OS<75 years: 29.2 mo≥75 years: 24.0 mo

S L I D E 5

Results

p=0.97

<75 years 126 77 37 14 3 2 0

≥75 years 127 76 28 19 6 1 0

Number at Risk

2-Year LPFS<75 years: 88.5%≥75 years: 86.2%

S L I D E 6

Results

Table 2. Overall Toxicity (grade > 3).Age

< 75 years old (n=126)

> 75 years old (n=127)

Acute 6.3% 4.7%

Increased Dyspnea/Pneumonitis

6 3

Fatigue 0 3Chest Wall Pain 0 0Other 2 0

Late 4.0% 3.9%Increased Dyspnea/Pneumonitis

3 4

Fatigue 0 0Chest Wall Pain 1 0Other 1 1

S L I D E 7

Conclusions

• To our knowledge, this is the largest single institution study to date evaluating safety and efficacy of SBRT in an elderly population.

• In our series, elderly patients undergoing SBRT appear to have achieved similar outcomes and toxicity compared to younger patients.