Inoperable non-small cell lung cancer: a retrospective analysis of 427 patients treated with high-dose radiotherapy.
OBJECTIVE
The influence of patient and treatment characteristics on survival as well as normal tissue toxicity were retrospectively analyzed.


METHODS
Four hundred twenty seven patients with unresectable non-small cell lung cancer received at least 60 Gy and two-thirds were treated with 70 Gy.


RESULTS
Five-year survival rates and median survival time (95% confidence interval) were 2 +/- 2% (mean +/- s.e.) and 11.1 months (9.1-14.5) after 60-66 Gy (median 60 Gy); 8 +/- 2% and 14.9 months (13.3-16.5) after > or = 70 Gy (p = 0.0013). Stage I-II patients had significantly higher survival rates as compared to Stage III patients (p = 0.0015). Within the subgroup of Stage III patients those with Stage IIIA had significantly higher survival rates than Stage IIIB (p = 0.0167). Female patients achieved 5-year survival rates after 70 Gy of 15 +/- 7% as compared to only 7 +/- 2% of their male counterparts. Chemotherapy, histology, Karnofsky status, and age had no influence on survival after univariate and multivariate analysis. Nine percent and 11% of the patients suffered from moderate to severe pneumonitis and esophagitis.


CONCLUSIONS
High-dose radiotherapy of unresectable non-small cell lung cancer with total doses > 60 Gy conventionally fractionated is feasible. With doses of > or = 70 Gy significantly higher survival rates were achieved as compared to 60-66 Gy. Normal tissue toxicity was acceptable. For Stage IIIB patients, however, treatment results are disappointingly low even after 70 Gy with no 5-year survivor.
Würschmidt
F
F
Hermann-Holthusen-Institut für Strahlentherapie 1, AK St. Georg, Hamburg, Germany.
Bünemann
H
H
Bünemann
C
C
Beck-Bornholdt
H P
HP
Heilmann
H P
HP
D000230:Adenocarcinoma / Q000453:epidemiology / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000532:radiotherapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate