Stereotactic body radiotherapy for single and multiple early-stage non-small cell lung cancer in patients aged ≥ 80 years - Research Open Access - Abstract

Sep 23, 2026

Study outcome and toxicity of stereotactic body radiotherapy (SBRT) are evaluated for elderly patients aged ≥ 80 years with histologically confirmed early-stage non-small cell lung cancer (NSCLC) and synchronous or metachronous multiple primary lung cancer (MPLC). A retrospective cohort of 118 patients receiving 141 SBRT-treated primary lung cancers assesses local control, progression-free survival, overall survival and cancer-specific survival. Results show high local control with low observed toxicity beyond grade 2, and age plus Charlson Comorbidity Index predict survival endpoints.

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Abstract

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Vorbach etal. Radiation Oncology (2025) 20:113 [https://doi.org/10.1186/s13014-025-02693-w](https://doi.org/10.1186/s13014-025-02693-w) Radiation Oncology RESEARCH Open Access Stereotactic body radiotherapy for single and multiple early-stage non-small cell lung cancer in patients aged ≥ 80 years Samuel M. Vorbach 1*, Thomas Seppi 1, Jan C. Peeken2,3,4, Manuel Sarcletti 1, Martin Pointner 1, Katharina Hörmandinger 1, Julian Mangesius 1, Meinhard Nevinny-Stickel 1 and Ute Ganswindt 1 Abstract Background Lung cancer primarily affects elderly individuals and is the leading cause of cancer-related death in people aged 80 years and older. In addition, the incidence of multiple primary lung cancer (MPLC) is increasing worldwide. Although surgery is recommended as the standard of care, many elderly patients are considered medically unsuitable, or they refuse surgery. The role of stereotactic body radiotherapy (SBRT) as an alternative treatment option for these elderly patients, particularly those with multiple primary lung cancer, has not been fully elucidated. Therefore, the aim of this study was to report the outcome and toxicities associated with SBRT for histologically confirmed early-stage non-small cell lung cancer (NSCLC) and synchronous and metachronous multiple primary lung cancer in patients aged ≥ 80 years. Methods This retrospective study included 118 patients aged ≥ 80 years with a total of 141 SBRT-treated primary lung cancers (19 patients with MPLC) . We assessed local control (LC), progression-free survival (PFS), overall survival (OS) and cancer-specific survival (CSS) . We further evaluated toxicities and factors impacting therapeutic efficacy. Results The median follow-up after SBRT was 47 months (range 3–169 months) . The LC rate was 96 . 2%(95% CI: 90.1 to 98 . 6%) two years and 86 .4%(71 . 8 to 93 . 8%) five years after SBRT for NSCLC/MPLC. The PFS and OS rates were 67. 0%(57 .4 to − 74 . 9%) and 74. 7%(65 .4 to − 81 . 1%), respectively, after two years and 24. 7%(14 . 5 to 35 . 6%) and 30. 2%(19 .4 to 41 . 7%), respectively, after five years. The CSS rate was 88 . 6%(80 .3–93. 6%) at two years and 76. 6%(61 .4–86.4%) at 5 years after SBRT. Age and the Charlson Comorbidity Index score were found to be independent predictors of OS and PFS. Predictors other than these patient-related factors could not be identified. Toxicities higher than Grade 2 after SBRT of NSCLC and MPLC were not observed. Conclusion This study emphasises the efficacy and safety of SBRT in the treatment of early-stage NSCLC in patients aged ≥ 80 years, including those with MPLC. SBRT proves to be an appropriate treatment modality for this frail patient group, as it provides favourable LC and CSS rates with low toxicity. Keywords Stereotactic body radiotherapy, Lung cancer, Elderly, Multiple primary lung cancer *Correspondence: Samuel M. Vorbach [Samuel.Vorbach@i-med.ac.at](Samuel.Vorbach@i-med.ac.at) 1Department of Radiation Oncology, Medical University of Innsbruck, Innsbruck, Austria 2Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany 3German Consortium for Translational Cancer Research (DKTK), Partner Site Munich, Munich, Germany 4Institute of Radiation Medicine (IRM), Helmholtz Zentrum München (HMGU), Neuherberg, Germany © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and you

FAQs

What population and cancer types were included in the study?

The study included 118 patients aged ≥ 80 years with 141 SBRT-treated primary lung cancers, including cases of synchronous and metachronous multiple primary lung cancer (MPLC). All cancers were histologically confirmed as early-stage NSCLC or MPLC.

How effective was SBRT in terms of local control, progression-free survival, and overall survival?

Local control was 96.2% at two years and 86.4% at five years for NSCLC/MPLC after SBRT. Progression-free survival was 67.0% at two years and 24.7% at five years, while overall survival was 74.7% at two years and 30.2% at five years.

What toxicity levels were observed after SBRT?

Toxicities higher than Grade 2 after SBRT for NSCLC and MPLC were not observed in the study results.

Which factors predicted survival outcomes?

Age and the Charlson Comorbidity Index score were identified as independent predictors of overall survival and progression-free survival.

Sep 23, 2026

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