Definitive Radiotherapy/Chemoradiotherapy Results in Geriatric Non-Small Cell Lung Cancer Patients with Multiple Comorbidity

INTRODUCTION: It was aimed to evaluate the definitive radiotherapy (RT)/chemoradiotherapy outcomes in geriatric non-small cell lung cancer (NSCLC) patients with multiple comorbidities.
METHODS: Patients who received RT 06.03.2019 and 24.10.2022 in XXX Hospital were analyzed retrospectively. The primary endpoints were RT interruption, acute adverse events (AAE), complete of treatment. The secondary endpoints were overall survival (OS), disease-free survival (DFS).
RESULTS: The results of 62 patients who received definitive RT/CRT were analyzed. Median follow-up time was 16 (2-55) months. The median age of the patients was 75(70-89) years. The median number of comorbidities was 3(2-6). Thirty-seven (59.7%) patients received concurrent chemotherapy (CRT);12(19.4%) patients received induction chemotherapy. One patient (1.6%) could not complete the RT and RT was interrupted in 6 (9.7%) patients. RT interruption was more common in patients with cerebrovascular disease (CVD) (p=0.002; OR5.5; CI %954,3-7). AAE were noted in 20 (32.3%) patients and AAEs increased with CRT (p=0.006; OR 6.2;95%CI1.5-24.4). Eighteen (29%) patients relapsed, 11(17.7%) of relapses were locoregional while 7 (11.3%) were distant. Median DFS was 12 (range1-50) months. Significantly higher DFS was observed in patients with squamous cell cancer (SCC) (p=0.021; HR 2.8;95%CI1.12-7.18). Thirty-three (53.2%) patients have died. Twenty-seven (81.8%) patients died without relapse, 6(17.2%) died after relapse. Median OS was 14 (2-50) months. Patients who interrupted RT had lower OS (p=0.003; HR5.96;95%CI2.23-15.9). Patients with 3≥ comorbidities had lower OS (14 vs10 months) (p=0.053; HR2.3;CI95%0.98-5.8).
DISCUSSION AND CONCLUSION: Definitive RT/CRT is an effective treatment with acceptable toxicity in geriatric NSCLC patients with multiple comorbidities.