Surgery or stereotactic body radiotherapy for elderly stage I lung cancer? A propensity score matching analysis.

Abstract:

PURPOSE:The aim of this study was to compare the outcomes of surgery and stereotactic body radiotherapy (SBRT) for elderly clinical stage I non-small cell lung cancer (NSCLC) patients. METHODS:Patients ≥80 years of age with clinical stage I NSCLC between August 2008 and December 2014 were treated either surgery or SBRT. Propensity score matching was performed to reduce bias in various clinicopathological factors. RESULTS:Surgery was performed in 57 cases and SBRT in 41 cases. In the surgery group, the operations included 34 lobectomies and 23 sublobar resections. In the SBRT group, 27 cases were given 48 Gy in 4 fractions, and 14 were given 60 Gy in 10 fractions. Similar characteristics were identified in age (82 years), gender (male:female ratio 2:1), tumor size (2.2 cm), carcinoembryonic antigen (3.6 ng/ml), Charlson comorbidity index (1), Glasgow prognostic scale (0), and forced expiratory volume in 1 s (1.7 L) after matching. Before matching, the 5-year overall survival (OS) in surgery (68.3%) was significantly better than that in SBRT (47.4%, p = 0.02), and the 5-year disease-specific survival (DSS) (94.1%, 78.2%, p = 0.17) was not significantly different between the groups. The difference in the 5-year OS became non-significant between the matched pairs (57.0%, 49.1%, p = 0.56). CONCLUSIONS:The outcomes of surgery and SBRT for elderly patients with the early stage NSCLC were roughly the same.

journal_name

Surg Today

journal_title

Surgery today

authors

Miyazaki T,Yamazaki T,Nakamura D,Sato S,Yamasaki N,Tsuchiya T,Matsumoto K,Kamohara R,Hatachi G,Nagayasu T

doi

10.1007/s00595-017-1536-4

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

1476-1483

issue

12

eissn

0941-1291

issn

1436-2813

pii

10.1007/s00595-017-1536-4

journal_volume

47

pub_type

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