Author of

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  P1.08 - Poster Session with Presenters Present (ID 460)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 17019

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    P1.08-084 - Treatment for Elderly Patients with Clinical Stage I Non-Small Cell Lung Cancer; Surgery or Stereotactic Body Radiotherapy? (ID 3906)

    14:30 - 14:30  |  Author(s): T. Yamazaki
    • Abstract
    • Slides

    Background:
    The number of elderly lung cancer patients requiring surgery has been increasing due to the aging society and less invasive perioperative procedures. Stereotactic body radiotherapy (SBRT) is one of the effective treatments for early stage non-small cell lung cancer (NSCLC). The aim of this retrospective study was to compare the outcome of pulmonary resection to SABR for elderly clinical stage I NSCLC in our hospital.
    
    Methods:
    Over 80-year-old patients with clinical stage I NSCLC between August 2008 and December 2014 were treated either surgery or SBRT at Nagasaki university hospital. Propensity score matching (PSM) was performed to reduce selection bias in various clinicopathological factors including age, gender, tumor size, carcinoembryonic antigen (CEA), Charlson comorbidity index (CCI), Glasgow prognostic scale (GPS) and forced expiratory volume in one second (FEV1.0) were compared between surgery and SBRT.
    
    Results:
    Pulmonary resection was performed in 57 cases, SABR in 41 cases. In surgery group, operations included 34 lobectomies, 23 limited resection (segmentectomy and wedge resections). Systemic lymph node dissection was 16 and limited dissection was 41 cases. In SABR group, 17 cases (41.5%) were not proven in histology. 27 cases were given 48 Gy by 4 fractions, 14 were 60 Gy by 10 fractions, respectively. No treatment deaths were observed. Before PSM, the 5 year overall survival (OS) in surgery (68.3%) was significantly better than that in SBRT (47.4%, p=0.02). the 5 year disease specific survival (DSS) (94.1%, 78.2%, p=0.17, respectively) was not significant. Similar characteristics were identified in age (82 years), gender, tumor size (2.2 cm), CEA (3.6 ng/ml), CCI (1), GPS (0) and FEV1.0 (1.7 Litter) after PSM. The difference in 5 year OS became insignificant between the matched pairs (57.0%, 49.1%, p=0.56, respectively). 5 year DSS was not significant (87.1%, 70.2%, respectively). Both treatments for elderly clinical stage I NSCLC were acceptable though unknown histology and precise lymph node status still existed as important bias.
    
    Conclusion:
    Surgery for early stage NSCLC is a safe and feasible treatment. SABR could be effective and a good option for early stage NSCLC.
    
    

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