Significant Rise in Survival Rates for Elderly Lung Cancer Patients

Using stereotactic ablative radiotherapy (SABR) to treat early stage lung cancer in both high-risk operable and inoperable cases shows significant improvements in survival of elderly lung-cancer patients, according to a new study.

Researchers at VU University Medical Center (VUMC; Amsterdam, The Netherlands) assessed the Netherlands Cancer Registry (NCR), a population-based registry containing individual data on all resident Dutch cancer patients, during three eras: 2001-2003 (no SABR); 2004-2006 (limited availability of SABR), and 2007-2009 (full access to SABR). The database includes demographic data, stage, and type of treatment, and it is electronically linked to municipal death registries, providing complete survival data. Chi-square, Kaplan-Meier, and Cox Regression were used to compare treatment utilization and survival after surgery, SABR, or neither treatment.

The results showed that a total of 4,605 patients aged 75 years or older were diagnosed with stage I NSCLC between 2001 and 2009. Surgery was performed in 1,698 of the patients (37%), SABR in 1,570 (34%), and neither in 1,337 (29%). Radiotherapy utilization increased between the periods, coinciding with a decrease in untreated patients (31.9% versus 24.9%). Median survival for all patients increased from 16.4 months in the first period to 24.4 months in the last. The greatest improvement in median overall survival was seen in SABR patients, with the median survival increasing from 16.8 months to 26.1 months. A smaller increase in survival was also observed in the surgical treatment group, but no significant change in survival was seen in the no-treatment group. The study was presented at the biennial World Conference for Lung Cancer (WCLC), held during July 2011 in Amsterdam (The Netherlands).

“Patients who are aged 75 years and older, and who are fit to undergo surgery, should also be informed about a second curative modality of SABR, and about the differences in mortality and complications between these two treatments,” said study coauthor Suresh Senan, MD. “Participation in the ongoing prospective clinical trials comparing surgery and SABR in fitter patient populations should be strongly encouraged.”

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