许多研究证明了立体定向放疗（SBRT）治疗老年早期非小细胞肺癌（NSCLC）患者的安全性和有效性。然而，这些研究主要针对周围型肺癌患者。本研究旨在评价单一机构SBRT治疗老年I-II期中心性NSCLC患者的临床疗效和毒性。2009年4月至2020年1月，对≥65岁I-II期NSCLC患者进行回顾性研究该疾病被集中本地化并在单一机构接受 SBRT 治疗。分析治疗前记录的绝对C反应蛋白（CRP）/白蛋白比（CAR）和体重指数（BMI）。终点包括总生存期 (OS)、无进展生存期 (PFS)、癌症特异性死亡、非癌症特异性死亡、局部进展 (LP) 和远处进展 (DP)。共 44 名患者。最常见的剂量分割方案是分 5 次给予 60 Gy。该队列的中位 PFS 为 31 个月（95% CI，19.47-42.53 个月）。所有患者的中位 OS 为 69 个月（95% CI，33.8-104.2 个月）。非癌症特异性死亡的中位时间为 54.5 个月。癌症特异性死亡的中位时间为 36 个月。 1年、5年和10年癌症特异性死亡的累积发生率分别为11.63%（95%CI，4.2-23.23%）、42.99%（95%CI，27.56-57.53%）和65.94%（95 %CI，45.76-80.1%）。 SBRT 前 BMI ≤ 22.77（HR 4.60，95% CI 1.84-11.51，P=0.001）和 SBRT 前 CAR ≤0.91（HR 5.19，95% CI 2.15-12.52，P<0.000）是较高风险的显着预测因素。多变量分析的操作系统。 LP 和 DP 的中位时间分别为 10 个月和 11 个月。急性毒性方面，常见1级，包括咳嗽（38.64%）、放射性肺炎（29.55%）、贫血（25%）和疲劳（20.45%）。没有证据表明存在 4 级或 5 级急性毒性。晚期毒性方面，2例患者在随访过程中出现1级肺纤维化。本研究表明，SBRT可以有效控制局部肿瘤进展，对于老年中心型I-II期NSCLC患者具有可接受的毒性。较低的 SBRT 前 BMI 和较低的 SBRT CAR 与癌症特异性死亡风险降低相关。版权所有 © 2024 Ji、Zhou、Huang、Wang、Jiang、Wang、Ding、Wang、Chen 和 Sun。

Many studies demonstrated the safety and efficacy of SBRT in the treatment of elderly patients with early-stage non-small cell lung cancer (NSCLC). However, those studies focused on patients with peripheral lung cancer. This study aimed to evaluate the clinical efficacy and toxicity of SBRT in elderly patients with stage I-II central NSCLC in single institution.From April 2009 to January 2020, a retrospective study was conducted on patients ≥ 65 years old with stage I-II NSCLC that was centrally localized and treated with SBRT at a single institution. Absolute C-reactive protein (CRP)/albumin ratio (CAR) and body mass index (BMI) recorded at pretreatment were analyzed. Endpoints included overall survival (OS), progression-free survival (PFS), cancer-specific death, noncancer-specific death, local progression (LP) and distant progression (DP).Stereotactic body radiation treatment (SBRT) was administered to a total of 44 patients. The most common dose fractionation schedule was 60 Gy given in 5 fractions. The median PFS of the cohort was 31 months (95% CI, 19.47-42.53 months). The median OS of all patients was 69 months (95% CI, 33.8-104.2 months). The median time to noncancer-specific death was 54.5 months. The median time to cancer-specific death was 36 months. The cumulative incidences of cancer-specific death at 1 year, 5 years, and 10 years were 11.63% (95%CI, 4.2-23.23%), 42.99% (95%CI, 27.56-57.53%), and 65.94% (95%CI, 45.76-80.1%), respectively. pre-SBRT BMI of ≤ 22.77 (HR 4.60, 95% CI 1.84-11.51, P=0.001) and pre-SBRT CAR of ≤0.91 (HR 5.19, 95% CI 2.15-12.52, P<0.000) were significant predictors of higher OS on multivariable analysis. The median times to LP and DP were 10 months and 11 months, respectively. In terms of acute toxicity, grade 1 including cough (38.64%), radiation pneumonitis (29.55%), anemia (25%), and fatigue (20.45%) was often observed. There was no evidence of grade 4 or 5 acute toxicity. In terms of late toxicity, 2 patients developed grade 1 pulmonary fibrosis during follow-up.This study showed that SBRT can effectively control local tumor progression, and have acceptable toxicity for elderly patients with centrally located stage I-II NSCLC. Lower pre-SBRT BMI and lower pre-SBRT CAR were associated with a decreased risk of cancer-specific death.Copyright © 2024 Ji, Zhou, Huang, Wang, Jiang, Wang, Ding, Wang, Chen and Sun.