Frailty decreases OS in NSCLC with SBRT

  • Raghavan G & al.
  • Clin Lung Cancer
  • 6 Jun 2018

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Frailty is significantly associated with worse OS in patients with NSCLC who undergo stereotactic body radiotherapy (SBRT).

Why this matters

  • A modified frailty index (mFI) could help better stratify risk and treatment planning.

Study design

  • 140 patients with early-stage NSCLC treated with SBRT.
  • mFI criteria of ≤2 as nonfrail and >2 as frail.
  • Funding: None disclosed.

Key results

  • 72.9% of the patients were aged >70 years.
  • 56.4% had adenocarcinoma; 55.0% with stage T1aN0.
  • 35.0% were frail and those patients were older (87.8% vs 64.8% >70 years; P=.007).
  • Median OS was 65.9 months, but median OS for frail patients was 58.7 months.
  • Frail patients had significantly worse OS compared with nonfrail patients (P=.01), with a 3-year OS of 59.3% vs 82.0% in nonfrail patients.
  • Local control (P=.02) and distant control (P=.03) were significantly worse in the frail group (3-year local control 85.3% vs 97.0% and 3-year distance control 80.6% vs 93.4%, respectively).
  • Recurrence-free survival was significantly worse in frail patients (P=.01), with overall RFS at 3 years of 67.3% (53.4% in frail and 74.5% in nonfrail patients).
  • After multivariable analysis, frailty was significantly associated with worse OS (HR, 1.98; 95% CI, 1.02-3.85).

Limitations

  • Single-center, retrospective study.

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