Hyperfractionated radiotherapy for clinical stage II non-small cell lung cancer

Background and purpose: Patients with stage II non-small cell lung cancer w ho are not suitable for or refuse surgery are treated with radiotherapy, bu t the results reported so far are not satisfactory. To improve the prognosi s of such patients, we have used hyperfractionated radiotherapy. In this pa per, we retrospectively analyzed results of the treatment. Materials and methods: Between 1988 and 1993, 67 patients were treated with hyperfractionated radiotherapy with 1.2 Gy twice daily to a total dose of 69.6 Gy. All patients were technically operable, but 43 had medical problem s and 24 refused surgery. The median age and Karnofsky performance status s core was 60 and 90 years, respectively. No patient received chemotherapy or immunotherapy. The median follow-up period was 61 months. Results: The median survival time and the 5-year survival rate were 27 mont hs and 25% (standard error, SE, 6%), respectively. The 5-year local control rate was 44% (SE, 7%). Univariate analysis of prognostic factors revealed that a higher Karnofsky performance status score, weight loss of less than or equal to 5% before treatment, and T1 stage were associated with better p rognosis, and peripheral location was of borderline significance (P = 0.053 ). There were two bronchopulmonary and two esophageal acute grade 3 toxicit ies, and one bronchopulmonary and two esophageal late grade 3 toxicities. N o grade 4 or 5 toxicity was observed. Conclusion: These results are encouraging and further studies on the use of hyperfractionation seem to he warranted for stage II non-small cell lung c ancer. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.