High-dose radiation therapy for elderly patients with inoperable or unresectable non-small cell lung cancer

Purpose: To evaluate definitive radiation therapy delivering doses in exces s of 60 Gy for elderly patients aged 75 years or over with non-small cell l ung cancer (NSCLC), Materials and methods: The treatment results for 97 pat ients aged 75 years or older (mean age 78 years; elderly group) with inoper able or unresectable NSCLC were retrospectively analyzed and compared with those for 206 patients younger than 75 year old (mean age 64 years; younger group). The elderly patients were classified into two groups. 67 patients aged 75-79 years (the elderly A) and 30 patients aged 80 years or older (th e elderly B). Most of all patients were treated with a total dose of 60 Gy or more in 2 Gy daily standard fractionation. Results: The overall 2 and 5 year survival rates were 32 and 13% for the elderly A group, and 28 and 4% for the elderly B group, respectively, compared with 36 and 12% for the you nger group. There was not a statistically significant difference in surviva l rates among three groups. In stage I-II NSCLC patients there was also no significant difference in survival curves among the three groups. In patien ts with stage III disease, however, the survival curve of the elderly B was inferior to those of the younger group and the elderly A group, although t he difference was not statistically significant. After the treatment the de terioration rate of the performance status was only 5% in the younger group and 8% in the elderly group. Only three younger and two elderly patients d ied of late pulmonary insufficiency associated with high-dose irradiation t o the proximal bronchus. No other treatment-related event was observed exce pt for mild acceptable acute complications in the elderly groups. Conclusio ns Definitive radiation therapy is recommended to the elderly aged 75 years or older with inoperable or unresectable NSCLC, especially early stage dis ease, as an acceptable choice of treatment. (C) 2001 Elsevier Science Irela nd Ltd. All rights reserved.