Hostname: page-component-84b7d79bbc-rnpqb Total loading time: 0 Render date: 2024-07-29T13:23:34.004Z Has data issue: false hasContentIssue false
  • English
  • Français

Outcome of the radical hypofractioned radiotherapy treatment in patients with stage I and II of non-small cell lung cancer

Published online by Cambridge University Press:  02 May 2012

Maria Wilczynska  and
Angel Garcia-Alonso
Maria Wilczynska*
Affiliation:
Respiratory Medicine Department, Prince Philip Hospital, Bryngwynmawr, Dafan, Llanelli, United Kingdom
Angel Garcia-Alonso
Affiliation:
Oncology Department, Glan Clwyd Hospital, Rhyl, Denbighshire, United Kingdom
*
Correspondence to: Maria Wilczynska, Respiratory Medicine Department, Prince Philip Hospital, Bryngwynmawr, Dafan, Llanelli, United Kingdom. Tel: +44 (0)1554 756567. E-mail: mwilczynska@doctors.org.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction: Surgery is the treatment of choice in stage I and II non-small-cell lung cancer (NSCLC). In the management of patients who are medically unfit to tolerate surgical intervention or who refuse surgery, radiotherapy is an acceptable alternative. We have performed a retrospective analysis of the effectiveness of radical radiotherapy in patients with early stage NSCLC treated over a period of 4 years.

Methods: Thirty nine patients treated with radiotherapy of radical intent were identified. All patients received hypofractionated radiotherapy with a total dose of 55Gy in 20 fractions.

Results: The median survival of all cases was 29 months. The one and two-year survival was respectively 61 % and 41%. The median survival of patients ≥75 years was 28 months, and age was the only prognostic factor identified in this analysis that affected survival.

Conclusions: The presented survival results are consistent with those from other series published in the literature. At present, radical radiotherapy is often offered to patients with medically inoperable stage I and II NSCLC or those who decline surgery. But there is emerging evidence that some new techniques like stereotactic radiotherapy could be also used in the operable, early stage NSCLC.

Keywords

lung cancerhypofractionated radiotherapystereotactic body radiation therapysurvival
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 12 , Issue 2 , June 2013 , pp. 139 - 145
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Alberg, AJ, Samet, JM. Epidemiology of lung cancer. Chest. 2003; 123:21S–49S.CrossRefGoogle ScholarPubMed
2.National Lung Cancer Audit, Report for the audit period 2005 The Information Centre for Health and Social Care and RCP, December 2006.Google Scholar
3.NICE. Lung cancer: diagnosis and treatment. 2005 ed. London: National Institute for Health and Clinical Excellence.Google Scholar
4.Greene FL, PD, Fleming, ID, Fritz, A, Balch, CM, HallerDG, M M DG, M M. AJCC cancer staging manual, 6th edn. Chicago: Springer, 2002.Google Scholar
5.Rowell, NP, Williams, CJ. Radical radiotherapy for stage I/II non-small cell lung cancer in patients not sufficiently fit for or declining surgery (medically inoperable). Cochrane Database Syst Rev. 2001:CD002935.CrossRefGoogle ScholarPubMed
6.Motohiro, A, Ueda, H, Komatsu, H, Yanai, N, Mori, T, National Chest Hospital Study Group for Lung C. Prognosis of non-surgically treated, clinical stage I lung cancer patients in Japan. Lung Cancer. 2002; 36:65–69.CrossRefGoogle Scholar
7.Morita, K, Fuwa, N, Suzuki, Y, et al. . Radical radiotherapy for medically inoperable non-small cell lung cancer in clinical stage I: a retrospective analysis of 149 patients. Radiother Oncol. 1997; 42:31–36.CrossRefGoogle Scholar
8.Lagerwaard, FJ, Senan, S, van Meerbeeck, JP, Graveland, WJ, Rotterdam Oncological Thoracic Study G. Has 3-D conformal radiotherapy (3D CRT) improved the local tumour control for stage I non-small cell lung cancer? Radiother Oncol. 2002; 63:151–157.CrossRefGoogle ScholarPubMed
9.Hayakawa, K, Mitsuhashi, N, Katano, S, et al. . High-dose radiation therapy for elderly patients with inoperable or unresectable non-small cell lung cancer. Lung Cancer. 2001; 32:81–88.CrossRefGoogle ScholarPubMed
10.Ataman, OU, Bentzen, SM, Saunders, MI, Dische, S. Failure-specific prognostic factors after continuous hyperfractionated accelerated radiotherapy (CHART) or conventional radiotherapy in locally advanced non-small-cell lung cancer: a competing risks analysis. Br J Cancer. 2001; 85:1113–1118.CrossRefGoogle ScholarPubMed
11.Saunders, M, Dische, S, Barrett, A, Harvey, A, Gibson, D, Parmar, M. Continuous hyperfractionated accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small-cell lung cancer: a randomised multicentre trial. CHART Steering Committee. Lancet. 1997; 350:161–165.CrossRefGoogle ScholarPubMed
12.Ghosh, S, Sujendran, V, Alexiou, C, Beggs, L, Beggs, D. Long term results of surgery versus continuous hyperfractionated accelerated radiotherapy (CHART) in patients aged >70 years with stage 1 non-small cell lung cancer. Eur J Cardiothorac Surg. 2003; 24:1002–1007.CrossRefGoogle ScholarPubMed
13.Andratschke, N, Zimmermann, F, Boehm, E, et al. . Stereotactic radiotherapy of histologically proven inoperable stage I non-small cell lung cancer: Patterns of failure. Radiother Oncol. 2011; 101:245–249.CrossRefGoogle Scholar
14.Olsen, JR, Robinson, CG, El Naqa, I, et al. . Dose-response for stereotactic body radiotherapy in early-stage non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2011; 81:e299–e303.CrossRefGoogle ScholarPubMed
15.Baba, F, Shibamoto, Y, Ogino, H, et al. . Clinical outcomes of stereotactic body radiotherapy for stage I non-small cell lung cancer using different doses depending on tumor size. Radiat Oncol. 2010; 5:81.CrossRefGoogle Scholar
16.Baumann, P, Nyman, J, Hoyer, M, et al. . Outcome in a prospective phase II trial of medically inoperable stage I non-small-cell lung cancer patients treated with stereotactic body radiotherapy. J Clin Oncol. 2009; 27:3290–3296.CrossRefGoogle Scholar
17.Bongers, EM, Haasbeek, CJ, Lagerwaard, FJ, Slotman, BJ, Senan, S. Incidence and risk factors for chest wall toxicity after risk-adapted stereotactic radiotherapy for early-stage lung cancer. J Thorac Oncol. 2011; 6:2052–2057.CrossRefGoogle ScholarPubMed
18.Haasbeek, CJ, Lagerwaard, FJ, Antonisse, ME, Slotman, BJ, Senan, S. Stage I nonsmall cell lung cancer in patients aged > or =75 years: outcomes after stereotactic radiotherapy. Cancer. 2010; 116:406–414.CrossRefGoogle ScholarPubMed
19.Louie, AV, Rodrigues, G, Hannouf, M, et al. . Stereotactic body radiotherapy versus surgery for medically operable stage I non-small-cell lung cancer: a markov model-based decision analysis. Int J Radiat Oncol Biol Phys. 2011; 81:964–973.CrossRefGoogle Scholar
20.Grills, IS, Mangona, VS, Welsh, R, et al. . Outcomes after stereotactic lung radiotherapy or wedge resection for stage I non-small-cell lung cancer. J Clin Oncol. 2010; 28:928–935.CrossRefGoogle ScholarPubMed