[The radiotherapy of inoperable non-small-cell bronchial carcinoma. A retrospective analysis of 427 cases].
BACKGROUND
The influence of tumor and patient characteristics on survival as well as acute normal tissue toxicity was retrospectively analyzed.


METHODS
427 patients with inoperable non-small cell lung cancer were retrospectively analyzed. Two thirds received a total dose of at least 70 Gy, and one third was irradiated with 60 to 66 Gy (2.0 to 2.5 Gy per fraction; split-course technique). 92% had a Karnofsky performance index of > or = 80%. Kaplan-Meier survival curves were generated and comparisons were made by the log-rank test. Prognostic factors were adjusted for by a proportional hazards analysis.


RESULTS
Five-year survival rates (+/- SE) and the median survival times (95% confidence interval) were 2 +/- 2% and 11.1 months (9.1 ... 14.5) after 60 to 66 Gy; 8 +/- 2% and 14.9 months (13.3 ... 16.5) after 70+ Gy. The difference was significant in univariate (p = 0.0013) and multivariate analysis (p = 0.0006). Tumor stage (p = 0.0029: I + II > III; IIIA > IIIB) and gender (p = 0.0387: female > male patients) reached significance in multivariate analysis. Acute pneumonitis and esophagitis were observed in 11% and 9% of cases.


CONCLUSIONS
Inoperable non-small cell lung cancer stage I to IIIA should be treated in a curative intention with total doses of about 70 Gy. This is feasible with acceptable normal tissue toxicity. Stage IIIB patients have a particular bad prognosis and should only be treated palliatively.
Würschmidt
F
F
Hermann-Holthusen-Institut für Strahlentherapie, AK St. Georg.
Bünemann
H
H
Bünemann
C
C
Beck-Bornholdt
H P
HP
Heilmann
H P
HP
D000368:Aged; D002283:Carcinoma, Bronchogenic / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005858:Germany / Q000453:epidemiology; D005860:Germany, West / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016019:Survival Analysis
Strahlentherapie des inoperablen nichtkleinzelligen Bronchialkarzinoms. Eine retrospektive Analyse von 427 Fällen.