Is Stereotactic Body Radiotherapy Safe and Effective in Lung Cancer Patients with Multiple Comorbidities?

Introduction: We examined the effectiveness and safety of stereotactic body radiotherapy (SBRT) in the treatment of lung tumors in Fraser Valley region of British Columbia, Canada.

Methodology: This is a retrospective chart review of lung tumors treated with SBRT from 2010 to 2020 at BC Cancer Abbotsford. We abstracted information on socio-demographic and disease characteristics, and treatment outcomes and toxicities (rib fractures, pneumonitis, and treatment related hospitalizations and deaths). Using descriptive statistics, Kaplan Meir and Cox regression models, we analyzed patient characteristics in relation to local control, survival and toxic events.

Results: From 2010 to 2020, a total of 150 lung tumors in 122 patients were treated with SBRT. Mean age was 75 ± 7 years, mean Charlson Comorbidity Index (CCI) was 6.6 ± 1.4 and mean tumor size was 2.23 ± 0.99 cm. Dosing regimen of 48 Gy/4 fractions was used in 112 (74%) patients. Median follow up was 25.6 months during which local control was observed in 136 (91%) tumors. At 5 years, progression free survival was 56% and overall survival was 27%. Tumor size and CCI were significantly associated with survival. Rib fracture was observed in four (3%) and pneumonitis in 18 (15%) patients.

Conclusion: In this cohort of lung cancer patients with advanced age and multiple comorbid conditions, SBRT was associated with high local control and low toxicity. The association of tumor size and CCI with survival underscores the importance of early cancer detection and treatment, and optimized management of comorbid conditions.

Conflict of interests: The authors declare no conflict of interest.

Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

License: © Author(s) 2026. This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, and unrestricted adaptation and reuse, including for commercial purposes, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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