Stereotactic Body Radiotherapy (SBRT) for Primary Non-Small Cell Lung Cancer (NSCLC) and Pulmonary Metastases: Analysis of Outcomes and Predictive Factors for Local Control

Abstract

Listen

Translate article

the oral cavity, oropharynx, nasopharynx, hypopharynx, and larynx, often managed with a combination of surgery, chemotherapy, and radiation therapy. Prognostic factors affecting treatment outcomes in the elderly have not been clearly defined in the literature. Patient-specific factors may be important when considering treatment options for this population in order to maximize patient survival and post-treatment quality of life (QOL). This study aims to explore and clarify the role of key prognostic factors on outcomes in HNC patients over the age of 80 years treated with radiation therapy at the Odette Cancer Centre (OCC). Methods and Materials: From a database of 933 HNC patients treated at OCC between Jan 2007 and December 2012, a sample of 40 eligible patients will be randomly selected. Prognostic factors identified from the literature will be extracted from relevant patient records and recorded in a database in three key categories: disease-related, treatment-related and patient-specific. Patient outcome datadoverall survival and rates of recurrence, treatment completion, and radiation toxicitydwill also be retrieved and recorded. Univariate analysis will be employed to determine which of the patient, disease, and treatment factors significantly predict for outcomes in this population. Results: 92.5% of patients successfully completed their treatment as prescribed. Though palliative patients (mean age 89, median 91) were likely to be older than radical patients (mean age 84.7, median 84), no connection was found between age and outcome measures. Dose, fractionation, and stage were not found to significantly impact outcomes in this sample. Mortality status was unavailable for 25% of patients. Further data collection is ongoing to confirm these and other findings. Conclusions: Preliminary results suggest that choice of treatment regime may be tailored to patient convenience without compromising outcome, and that many older patients are able to successfully complete even aggressive radical therapy. The results of this study and the database from which the sample was drawn may be useful in further studies to inform practices in the HN site group at OCC. Prognostic data may also be utilized to create a medical nomogram, in the form of a visual tool useful in facilitating patient-specific education during the informed consent procedure.