Survival of patients in clinical stages I-IIIb of non-small-cell lung cancer treated with radiation therapy alone. Results of a population-based study in Southern Saxony-Anhalt.
OBJECTIVE
Up to now, evidence about survival of patients with non-small-cell lung cancer treated with radiation therapy alone is only available from clinical studies. The authors analyzed survival experience depending on several prognostic factors from a population-based cancer registry and compared this to survival data from the literature.


METHODS
Between April 1996 and September 1999, 1,696 patients with lung cancer were recruited by the Halle Lung Cancer (HALLUCA) Study. 1,183 patients were diagnosed as having non-small-cell lung cancer, and 188 in clinical stages I-IIIb (15.9%) were treated with radiation therapy alone.


RESULTS
The median survival time of all patients was 10.2 months, the 2-year overall survival rate amounted to 15.8%. Besides tumor stage, radiation dose was found to be a statistically significant prognostic factor for survival in univariate analysis. The median survival time was 4.2 months for 66 patients treated with < 50 Gy, 10.7 months for 80 patients treated with 50 to < 60 Gy, and 18.9 months for 42 patients treated with >/= 60 Gy; the corresponding 2-year overall survival rates were 8.7%, 13.4%, und 35.2%. The significant influence of dose persisted even after adjustment for different confounders in a Cox regression model.


CONCLUSIONS
Patients treated with 50 to < 60 Gy under a potentially curative therapeutic regimen had a significantly lower survival, compared to patients treated with >/= 60 Gy. In terms of quality assurance, the large proportion of patients treated with radiation doses below the curative range of >/= 60 Gy was unexpected.
Clinical Cancer Registry, Martin Luther University of Halle-Wittenberg, Halle, Germany. anja.bollmann@medizin.uni-halle.de
Anja
A
Bollmann
Thomas
T
Blankenburg
Johannes
J
Haerting
Oliver
O
Kuss
Wolfgang
W
Schütte
Jürgen
J
Dunst
Heinz
H
Neef
D000368:Aged; D000704:Analysis of Variance; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005858:Germany; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D012044:Regression Analysis; D016019:Survival Analysis; D013997:Time Factors