Background and purpose: Radiotherapy can effectively control non-small
cell lung cancers (NSCLC) of limited size. This study is conducted to
investigate whether limited field irradiation, without irradiation of
regional lymph nodes, can safely be used in these patients. Materials
and methods: Between 1988 and 1993, 31 patients with operable T1-2N0
NSCLC received radiotherapy (48 Gy in 12 fractions) to a limited ('pos
tage stamp') field. The hilum and mediastinum were not included in the
radiation portals. Results: Overall survival was 42% at 3 years. Dise
ase-specific survival at 3 years was 76%. One patient developed an iso
lated regional failure, one had a combined local and distant failure,
one had a combined local, regional and distant failure, while three pa
tients failed at distant sites only. Thus, only two patients (6%) recu
rred regionally. Conclusions: This study shows that 'postage stamp' ir
radiation is an effective alternative to sugery. Radiation of the hila
r and mediastinal lymph nodes can be omitted in these pulmonary compro
mised patients.