RADICAL RADIOTHERAPY FOR EARLY NONSMALL CELL LUNG-CANCER

Purpose: To evaluate the results of a departmental treatment policy in a consecutive series of patients with nonsmall cell carcinoma of the lung. A second purpose was to estimate the survival of patients treate d with radical intent. A third purpose was to estimate the impact of c omorbidity on the selection of patients for treatment and on its outco me. Methods and Materials: The records of 720 consecutive patients ref erred to a single Department of Radiation Oncology between 1979 and 19 85 were reviewed. One hundred fifty patients with early stage (Stage I and II disease) were studied in detail and the results are presented for the outcome of 103 patients treated by radical radiotherapy. All p atients were followed for a minimum period of five years or until deat h. Results: Patients referred for radiation therapy were elderly and u sually had squamous cell carcinoma of the lung. Comorbidity was signif icant as was weight loss which occurred in a third of patients. The ov erall survival of patients treated with radical intent was 13%. In a s mall subgroup of patients with T-1 tumors without weight loss and aged under 70 survival reached 50% at 5 years with no treatment-related mo rtality and with insignificant treatment-related morbidity. Conclusion : Highly selected subsets of patients suitable for treatment with radi otherapy can be defined equally as well as highly selected subsets of patients can be selected for surgery. Treatment outcome can be surpris ingly good in these subsets indicating that the treatment of nonsmall cell lung cancer, particularly in older patients without comorbidity s hould not automatically be by a surgical approach.