RADICAL RADIOTHERAPY FOR MEDICALLY INOPERABLE NONSMALL CELL LUNG-CANCER IN CLINICAL STAGE .1. A RETROSPECTIVE ANALYSIS OF 149 PATIENTS

Purpose: In order to obtain the standard treatment results of medicall y inoperable non-small cell lung cancer (NSCLC) in Stage I in the post -CT scan era, a retrospective analysis of patients who were treated by radical radiotherapy was performed. Methods and materials: 149 cases treated between 1980 and 1989 were accumulated from ten large hospital s in Japan. All patients received a total dose of 55-75 Gy (mean 64.7 Gy) with conventional fractionation. For evaluation of treatment resul ts, complete response (CR) rate, median survival period and long-terme d survival rates were used. Results: The median survival of the all ca ses was 27.2 months and the actuarial 3- and 5-year survival rates wer e 34.2% and 22.2%, respectively. CR was obtained in 57 cases (38%). Th e CR rate was strongly correlated with the long-term survival (5-year survival rate in CR group: 35.1% compared with PR+NC group: 14.1% (P<0 .0001)). The size of tumor was also of prognostic importance. In 116 p atients who died within 5 years after treatment, 66 patients (57%) die d of local tumor regrowth. Conclusion: Although the medically inoperab le NSCLC patients in Stage I should be offered curative radiation ther apy, development of some new steps to increase the CR rate and local c ontrol rate is urgently needed. (C) 1997, Elsevier Science Ireland Ltd .