External beam radiation therapy alone for loco-regional recurrence of non-small-cell lung cancer after complete resection

Between January 1982 and June 1993, a total of 61 patients with post-surgic al loco-regional recurrence only were treated with external beam radiation therapy only at our institution. Patients were treated with either curative intent [tumor dose (TD) 55-60 Gy in 26-30 fractions] or palliative intent (TD 30 Gy in ten fractions). Median survival time (MST) for all 61 patients is 13 months, and 1-5-year survival rates are 61, 28, 16, 9.8 and 9.8%, re spectively. There was a significant difference between high-dose and low-do se RT groups regarding both MST (18 vs. 7 months, respectively) and 1-5-yea r survival rates (74, 36, 24, 14 and 14% vs. 32, 11, 0, 0 and 0%, respectiv ely) (P = 0.0000). Age, extent of initial surgery, time from initial surger y to documented recurrence were not found to influence survival in the high -dose group and influence of performance status, weight loss and histology were only marginally insignificant. Females did better than males and patie nts with bronchial stump recurrence only did better than those with non-stu mp recurrence only. Initial and recurrent staging significantly influenced survival, with patients in early stages doing better than those in advanced stages; External beam RT is an effective tool in the treatment of loco-reg ional recurrent NSCLC after curative resection. Identification of a favorab le subset of patients that may fare better may help optimize treatment in t he future by using high-dose, curative RT. Otherwise, unfavorable patients may appropriately be treated with palliative RT. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.