RADIATION-THERAPY FOR STAGE-III NONSMALL CELL LUNG-CANCER INVADING CHEST-WALL

The treatment outcome and prognostic factors for Stage III non-small c ell lung cancer (NSCLC) invading the chest wall and treated with defin itive radiation therapy alone were investigated. From 1976 to 1990, 40 consecutive patients with Stage III NSCLC invading the chest wall und erwent radiation therapy alone. There were 31 with Stage IIIA and nine with Stage IIIB. Squamous cell carcinoma was present in 30 patients ( 75%). All the patients underwent radiation therapy at a total dose of 60-80 Gy at 2 Gy per fraction. Local pain completely disappeared in 11 /13 (85%) and decreased in the remainder after treatment. The 5-year s urvival rate was 8% for all patients, 10% for Stage IIIA and 0% for II IB (P = 0.02), 11% for lesions invading the parietal pleura and 0% for those invading the ribs or spine (P = 0.2). Good performance status, Stage IIIA, metastases of lymph nodes less than N3 and small tumor siz e were better prognostic factors by univariate analysis. By multivaria te analysis, performance status (P = 0.01) and Stage (P = 0.03) were t he important prognostic factors. Five-year local progression-free surv ival rates were 51% for patients with lesions invading the parietal pl eura and 0% for those invading the ribs or spine (P = 0.009). Good pai n relief was achieved in patients with lesions invading the ribs or sp ine by radiation therapy. Tumors invading the parietal pleura were fai rly well controlled by radiation therapy alone. (C) 1997 Elsevier Scie nce Ireland Ltd.