RADIATION-THERAPY FOR STAGE I-II NON-SMALL-CELL LUNG-CANCER IN PATIENTS AGED 75 YEARS AND OLDER

Between 1976 and 1992, 32 patients aged 75 and older with stage I-II n on-small cell lung cancer (NSCLC) were given definitive radiation ther apy. These patients did not undergo surgery because of old age, poor c ardiac/pulmonary condition, or refusal to give consent. The mean age w as 79 years, and 11 patients were over 80 years old. The histologic ty pe was squamous cell carcinoma in 25 patients and adenocarcinoma in 7. The clinical T and N stage was T1N0 in 4 patients, T2N0 in 9, and T2N 1 in 19. The total dose of radiation therapy given to each patient exc eeded 60 Gy using 10-MV X-rays. The treatment was completed in all 32 patients without treatment-related complications. The 2- and 5-year ov erall actuarial survival rates were 40% and 16%, respectively. Eleven intercurrent deaths occurred, including 7 patients who died of heart d isease. The 2- and 5-year cause-specific survival rates were 57% and 3 6%, respectively. None of the patients developed severe pneumonitis re quiring hospitalization. All but three patients received radiation the rapy on an inpatient basis. The mean duration of the hospital stay for initial treatment was 56 days, and mean ratio to total survival perio d (mean 739 days) was 8%. Although many elderly patients have concurre nt medical complications such as heart disease and chronic pulmonary d isease, the present study showed that elderly patients with clinical s tage I-II NSCLC can expect a realistic probability of long-term surviv al with definitive radiation therapy.