Real-world insights into moderately hypofractionated thoracic radiotherapy in elderly and multimorbid patients with stage II/III NSCLC: a retrospective study
Purpose: Investigating real-world outcomes of moderately hypofractionated radiotherapy (hypoRT) in elderly and multimorbid stage IIB–IIIC non-small-cell lung cancer (NSCLC) patients ineligible for concurrent chemoradiation. Methods: We retrospectively analysed 70 patients with primary or recurrent...
Saved in:
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Medical Journals Sweden
2025-07-01
|
| Series: | Acta Oncologica |
| Subjects: | |
| Online Access: | https://medicaljournalssweden.se/actaoncologica/article/view/43496 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Purpose: Investigating real-world outcomes of moderately hypofractionated radiotherapy (hypoRT) in elderly and multimorbid stage IIB–IIIC non-small-cell lung cancer (NSCLC) patients ineligible for concurrent chemoradiation.
Methods: We retrospectively analysed 70 patients with primary or recurrent stage IIB–IIIC NSCLC (TNM, 8th edition). HypoRT was administered to a total dose of 38–56 Gy in 10–17 fractions (2.5–3.8 Gy/fraction). Patterns of recurrence, survival outcome, and toxicity were assessed.
Results: Seventy patients, with a median age of 76.4 years (range: 51.6–88.2 years), who received hypoRT between August 2015 and September 2022, were reviewed. At baseline, the median Charlson Comorbidity Index (CCI) with oncological diagnosis was 8 (range: 3–13). With a median follow-up post-radiotherapy of 63.9 months (95% Confidence Interval [CI]: 34.8–93.1 months), median progression-free survival (PFS) was 7.6 months (95% CI 6.0–11.0 months), and the median overall survival (OS) was 20.7 months (95% CI 16.7–30.7 months). Competing risk analysis revealed 12-month cumulative incidences of locoregional and distant failure in 41% (95% CI 30–53%) and 14% (95% CI 6–23%) of patients, respectively. Following disease progression, 45 patients received subsequent therapy: 25 underwent additional radiotherapy, 22 received systemic treatment (including immunotherapy), and 19 were referred for best supportive care. Treatment was well tolerated; only 3 patients (4%) developed grade 3 pneumonitis. No adverse events of grade > 3 were reported.
Interpretation: Moderately hypoRT is a safe, feasible, and effective treatment option for elderly and multimorbid patients with stage IIB–IIIC NSCLC, offering encouraging survival outcomes and low toxicity rates. Future prospective studies are needed to validate these findings and optimise treatment strategies for this high-risk population.
|
|---|---|
| ISSN: | 1651-226X |