PROGNOSTIC FACTORS IN LOCOREGIONAL NONSMALL CELL LUNG-CANCER TREATED WITH RADIOTHERAPY

By means of a retrospective study an evaluation was made of prognostic factors on survival in patients with inoperable locoregional non-smal l cell lung cancer. The study was performed on a group of 239 patients with a median age of 69 years, 225 men, and 14 women. Patients were t reated with external radiotherapy without(184) or with (55) chemothera py. They received either continuous-course radiotherapy (5,500 cGy in 27-28 fractions and 5.5 weeks) or split-course radiotherapy (1 series of 3,000 cGy, 2 series of respectively 3,000 cGy and 2,500 cGy, or 3 s eries of, respectively 3,000 cGy, 2,500 cGy, and 2,000 cGy; each serie s in 10 fractions and 2 weeks, separated by a 4-week interval). Univar iate analysis was done by life-table analysis and log-rank test, multi variate analysis by the Cox Proportional Hazards model. The overall su rvival at 1, 2, and 3 years was 36%, 11%, and 4%. Survival was not sig nificantly influenced by localization of the tumor, grading, distance to the carina, growth pattern, diameter, partial or total atelectasis, lymph node invasion or stage. No significant difference in survival w as found between patients who received only radiotherapy and those tre ated with a combination of radiotherapy and chemotherapy. Univariate a nalysis showed significant better survival in patients with squamous c ell epithelioma, patients without pleural effusion, patients younger t han 75 years and patients receiving higher radiation doses. Multivaria te analysis showed dose of radiation (P < .001) and pleural effusion ( P = .03) to be independent prognostic factors.