PMID- 28941581
OWN - NLM
STAT- MEDLINE
DCOM- 20190812
LR  - 20220409
IS  - 1879-4076 (Electronic)
IS  - 1879-4068 (Linking)
VI  - 9
IP  - 2
DP  - 2018 Mar
TI  - Use of frailty to predict survival in elderly patients with early stage 
      non-small-cell lung cancer treated with stereotactic body radiation therapy.
PG  - 130-137
LID - S1879-4068(17)30183-2 [pii]
LID - 10.1016/j.jgo.2017.09.002 [doi]
AB  - OBJECTIVES: Frailty has been shown to increase morbidity and mortality 
      independent of age, but studies are lacking in radiation oncology. This study 
      evaluates a modified frailty index (mFI) in predicting overall survival (OS) and 
      non-cancer death for Stage I/II [N0M0] Non-Small-Cell Lung Cancer (NSCLC) 
      patients treated with Stereotactic Body Radiation Therapy (SBRT). MATERIALS AND 
      METHODS: Medical records for all patients with Stage I/II NSCLC treated at our 
      institution with SBRT from 2009 to 2014 were reviewed. A validated mFI score, 
      consisting of 11 variables was calculated, classifying patients as non-frail 
      (0-1) or frail (>/=2). Primary endpoint (OS) was analyzed using Kaplan-Meier method 
      and log-rank. Secondary endpoint, non-cancer death, was analyzed using 
      Fine-Gray's method, with death from lung cancer as a competing risk. RESULTS: 
      Patient cohort consisted of 38 (27.3%) non-frail and 101 (72.7%) frail [median 
      total mFI score 3.0 (range 0-7)]. Median age and pack-year history was 74 and 
      46years, respectively. Median follow-up among survivors was 38.5months (range 
      4.0-74.1months). Frailty was associated with a lower 3-year OS (37.3% vs. 74.7%; 
      p=0.003) and 3-year cumulative incidence of non-cancer death (36.7% vs. 12.5%; 
      p=0.02). Frailty remained significant in the multivariate model [OS HR for mFI 
      >/=2: 2.25 (1.14-4.44); p=0.02]. CONCLUSION: Frailty is associated with lower OS in 
      older patients with early stage NSCLC treated with SBRT, yet frail patients 
      survived a median 2.5years, and were more likely to die of causes unrelated to 
      the primary lung cancer, suggesting SBRT should be considered even in older 
      patients deemed unfit for surgery.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Franco, Idalid
AU  - Franco I
AD  - Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and 
      Women's Hospital, Harvard Medical School, Boston, MA 02115, United States. 
      Electronic address: IFRANCO@LROC.HARVARD.EDU.
FAU - Chen, Yu-Hui
AU  - Chen YH
AD  - Department of Biostatistics and Computational Biology, Dana-Farber Cancer 
      Institute, Boston, MA 02115, United States.
FAU - Chipidza, Fallon
AU  - Chipidza F
AD  - Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and 
      Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
FAU - Agrawal, Vishesh
AU  - Agrawal V
AD  - Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and 
      Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
FAU - Romano, John
AU  - Romano J
AD  - Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and 
      Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
FAU - Baldini, Elizabeth
AU  - Baldini E
AD  - Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and 
      Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
FAU - Chen, Aileen
AU  - Chen A
AD  - Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and 
      Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
FAU - Colson, Yolonda
AU  - Colson Y
AD  - Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA; Harvard 
      Medical School, Boston, MA 02115, United States.
FAU - Hou, Ying
AU  - Hou Y
AD  - Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and 
      Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
FAU - Kozono, David
AU  - Kozono D
AD  - Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and 
      Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
FAU - Wee, Jon
AU  - Wee J
AD  - Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA; Harvard 
      Medical School, Boston, MA 02115, United States.
FAU - Mak, Raymond
AU  - Mak R
AD  - Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and 
      Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
LA  - eng
PT  - Journal Article
DEP - 20170921
PL  - Netherlands
TA  - J Geriatr Oncol
JT  - Journal of geriatric oncology
JID - 101534770
MH  - Aged
MH  - Carcinoma, Non-Small-Cell Lung/*mortality/radiotherapy
MH  - Case-Control Studies
MH  - Female
MH  - Frailty/classification/diagnosis/*mortality
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Lung Neoplasms/*mortality/radiotherapy
MH  - Male
MH  - Neoplasm Staging
MH  - Radiosurgery/*mortality
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Elderly
OT  - Frailty
OT  - Non-small cell lung cancer
OT  - Radiation
OT  - SBRT
EDAT- 2017/09/25 06:00
MHDA- 2019/08/14 06:00
CRDT- 2017/09/25 06:00
PHST- 2017/01/31 00:00 [received]
PHST- 2017/07/31 00:00 [revised]
PHST- 2017/09/01 00:00 [accepted]
PHST- 2017/09/25 06:00 [pubmed]
PHST- 2019/08/14 06:00 [medline]
PHST- 2017/09/25 06:00 [entrez]
AID - S1879-4068(17)30183-2 [pii]
AID - 10.1016/j.jgo.2017.09.002 [doi]
PST - ppublish
SO  - J Geriatr Oncol. 2018 Mar;9(2):130-137. doi: 10.1016/j.jgo.2017.09.002. Epub 2017 
      Sep 21.