Background/Objectives: The global population of individuals aged ≥ 80 years is rapidly growing, leading to an increasing incidence of cancer diagnoses in this age group. While stereotactic body radiotherapy (SBRT) has proven effective in treating pulmonary oligometastases, patients over 80 remain underrepresented in clinical analyses. This study aimed to evaluate clinical outcomes and toxicity of SBRT for pulmonary oligometastases in octogenarians. Methods: This retrospective, single-centre analysis included 34 patients aged ≥ 80 years treated with SBRT for histologically confirmed pulmonary oligometastases between 2010 and 2024. Results: A total of 46 pulmonary metastases were treated with curative intent using fractionation schemes of 3 × 15 Gy, 6 × 8 Gy, or 10 × 6 Gy. Median biologically effective dose (BED10) was 112.5 Gy. Follow-up included regular CT imaging and toxicity assessment according to CTCAE. With a median follow-up of 22.6 months, 1-, 2-, and 3-year local control (LC) rates were 95.2%, 95.2%, and 90.2%, respectively. Median overall survival (OS) was 46.6 months, with 1-, 2-, and 3-year OS rates of 78.4%, 71.4%, and 59.5%. Progression-free survival (PFS) at 1, 2, and 3 years was 63.4%, 51.6%, and 47.3%, respectively. No grade ≥ 3 toxicities were observed. Grade 2 pneumonitis and dermatitis occurred in 2.9% each and were well managed. Asymptomatic rib fractures were detected in 5.9% of patients. No significant predictors for LC, PFS, or OS were identified in univariate analysis. Conclusions: SBRT for pulmonary oligometastases in patients ≥ 80 years is feasible, safe, and effective. High local control, favourable cancer-specific survival, and minimal toxicity support its use as a curative-intent treatment in this growing patient population. These findings contribute important site- and age-specific evidence and support the inclusion of very elderly patients in future prospective SBRT trials.
背景/目的：全球80岁及以上人口快速增长，导致该年龄组癌症诊断率持续上升。立体定向体部放疗（SBRT）已被证实对肺寡转移灶具有确切疗效，但80岁以上患者在临床分析中代表性仍然不足。本研究旨在评估SBRT治疗80岁以上肺寡转移患者的临床疗效与毒性反应。 方法：本项回顾性单中心分析纳入2010年至2024年间34例经组织学确诊的肺寡转移灶并行SBRT治疗的≥80岁患者。 结果：共46个肺转移灶采用根治性剂量分割方案（3×15 Gy、6×8 Gy或10×6 Gy）进行治疗。中位生物有效剂量（BED10）为112.5 Gy。随访期间定期行CT影像学检查，并依据CTCAE标准评估毒性反应。中位随访时间22.6个月，1年、2年和3年局部控制率分别为95.2%、95.2%和90.2%。中位总生存期为46.6个月，1年、2年和3年总生存率分别为78.4%、71.4%和59.5%。1年、2年和3年无进展生存率分别为63.4%、51.6%和47.3%。未观察到≥3级毒性反应。2级放射性肺炎和皮炎发生率均为2.9%，均得到良好控制。5.9%患者检出无症状性肋骨骨折。单因素分析未发现影响局部控制、无进展生存或总生存的显著预测因素。 结论：SBRT治疗80岁以上肺寡转移患者具有可行性、安全性和有效性。其高局部控制率、良好的肿瘤特异性生存率及轻微毒性反应，支持将该疗法作为这一增长型患者群体的根治性治疗选择。本研究提供了重要的特定部位与年龄层证据，支持将高龄患者纳入未来前瞻性SBRT临床试验。
SBRT in the Very Elderly: A Viable Option for Pulmonary Oligometastases?
肿瘤(癌症)患者之家