17.06.2014:  Stereotactic Radiotherapy as an alternative treatment in elderly patients with early Lung Cancer

For elderly patients with early Non-Small Cell Lung Cancer (NSCLC) surgery might not be the ideal option mainly due to comorbidity. Chronic obstructive lung disease, diabetes, cardiovascular disease etc. make surgery extremely risky for morbidity. About 30% for patients more than 75 year old are not candidates for proper treatment. This is the group of patients in whom Stereotactic radiotherapy (SBRT) plays an important role. With this technique, high volume radiation is focused to the lung tumor bed only, without affecting the surrounding normal tissues.
In a study of 328 patients with inoperable lung cancer due to medical reason, SBRT achieved local control in 91% of them with an overall survival 52% for 3 years. As a matter of fact in some patients biopsy is not available because of poor performance status.
SBRT is now a widely used method of treatment for these patients with peripheral lesions of less than 3cm in diameter.
Certainly, in medically fit patients, surgery is still a preferable method of treatment. However, SBRT is a possible alternative option with similar results although randomized controlled trials do not exist.