Stereotactic Ablative Body Radiotherapy in Non-small Cell Carcinoma Lung in Elderly: Initial Experience from a Rural Tertiary Cancer Centre

Aim: The aim of this study was to evaluate the efficacy and outcome of early stage non-small cell lung carcinoma in elderly patients treated with SABR in a tertiary care cancer centre in rural India. Materials and methods: This was a retrospective study. All cases of histopathologically proven, stage 1 lung cancer patients in whom surgical management was not feasible due to various reasons were included. It included patients treated from 2013 to 2018 at our centre. Case records and radiation treatment plans were reviewed and data was collected. All were T1/T2N0 cases. Dose schedules employed were 48 Gy in 4 fractions, 60 Gy in 5 fractions and 60 Gy in 3 fractions. The primary end point was the tolerance and toxicity profile. Results: A total of 5 patients were treated at our center from 2013 to 2017. All were males. Mean age was 72 years. One had squamous cell and four had adenocarcinoma histology. The dose fractionation schedules employed where 48 Gy in 4 fractions, 60 Gy in 5 fractions and 60 Gy in 3 fractions. All tolerated treatment well. No grade 3 or 4 toxicities were observed. Conclusion: SABR is a feasible alternative curative treatment modality in stage 1 NSCLC. It is feasible and was tolerated well even in the elderly age group. This can be offered to medically inoperable patients as a curative treatment and is possible in a resource constrained setting also. This modality is a promise to future for operable stage 1 NSCLC also. But more randomized studies need to be carried out before applying it to operable lung cancer patients.