Kazuhiko - solid lcbi - EAN-Search.org: 4000000000000 and higher (Page 24238)


Background:
Overall survival ﴾OS﴿ for medically inoperable patients with localized non‐small cell lung cancer ﴾NSCLC﴿ treated with stereotactic body radiotherapy ﴾SBRT﴿ is poorer than for patients undergoing surgery. A possible explanation is contribution of comorbidities to the mortality. Klement et al. demonstrated that comorbidity did not predict the risk of early death for patients with localized NSCLC treated with SBRT. However, it was suggested that a comprehensive geriatric assessment (CGA) could improve OS. We have performed a randomized study to investigate whether CGA added to SBRT impact quality of life ﴾QoL﴿ and OS.

Method:
From January 2015 to June 2016 51 patients diagnosed T1‐2N0M0 NSCLC were enrolled. The patients were randomized 1:1 to receive SBRT +/‐CGA. EQ‐5D QoL health-index and VAS-scores were assessed at start of SBRT, at 5 weeks, and every third months for a year after SBRT. Repeated measures ANOVA compared EQ‐5D overall scores and changes from baseline. OS was analyzed by Kaplan‐Meier methods and compared with log‐rank test.

Result:
26 vs. 25 patients were randomized in the groups +/-CGA, respectively. 4 patients dropped out. There were no differences in patient characteristics between groups. In both groups QoL decreased from baseline but with no differences between groups. VAS scores decreased significantly in the no-CGA group (Table 1). The 1-year and potential 2-year OS was 92% vs. 73% and 72% vs. 57% for the groups +/-CGA, respectively (p=). Figure 1



Conclusion:
In patients treated with SBRT for a localized NSCLC, a CGA did improve the subjective opinion (VAS-score) of QoL at 12 months follow up. A CGA did not statistically improve the health index of QoL and OS. However, more patients deceased within the first 12 months after SBRT in the group without a CGA performed. This study suggests that CGA may prevent early death and improve the patients’ subjective opinion of QoL after SBRT.




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