High-dose Radiation Therapy alone for Inoperable Non-small cell Lung Cancer: Experience with Prolonged Overall Treatment Times
| Autor: | Florian Würschmidt, Henning Willers, H. Bünemann, H. P. Heilmann |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Carcinoma Non-Small-Cell Lung medicine Humans Radiology Nuclear Medicine and imaging Stage (cooking) Lung cancer Aged Neoplasm Staging Aged 80 and over Performance status business.industry Respiratory disease Hematology General Medicine High-dose radiation Middle Aged Prognosis medicine.disease Survival Analysis Surgery Radiation therapy Oncology Radiological weapon Female Non small cell business |
| Zdroj: | Acta Oncologica. 37:101-105 |
| ISSN: | 1651-226X 0284-186X |
| DOI: | 10.1080/028418698423258 |
| Popis: | The purpose of this study as to determine the impact of overall treatment time on long-term survival after high-dose radiation therapy alone for inoperable non-small cell lung cancer (NSCLC). Between 1978 and 1990, 229 patients with stage I-III disease and Karnofsky Performance Scores of 80-100 received a conventionally fractionated total dose of 70 Gy through a split-course technique. After a first treatment course of 40 or 50 Gy, a restaging was performed and only patients without any contraindications, such as newly diagnosed distant metastases or serious deterioration of performance status, were given a second course. In 83% of patients this break lasted for 4-6 weeks. Overall treatment time ranged between 7 and 24 weeks (median 12 weeks). Median follow-up time was 6.6 years (range 4.0-9.3 years). Actuarial overall survival rates at 2 and 5 years were 28% and 7% respectively. Complete radiological tumor response was observed in 31% of patients, and was found to be the strongest positive predictor of survival with 2- and 5-year rates of 50% and 12% respectively compared with 17% and 4% for patients without complete response. Treatment duration was not found to be a significant prognostic factor in univariate or multivariate analysis. For overall treatment times of 7-11 weeks (n = 50), 12 weeks (n = 79) and12 weeks (n = 100), 5-year survival was 4%, 6%, and 8%, respectively (p = 0.6). To conclude, in our experience and in contrast to other studies, prolonged overall treatment times in radiation therapy alone for inoperable NSCLC had no negative impact on long-term survival. It is hypothesized that accelerated tumor cell repopulation is absent in a significant number of these patients with the time-factor playing no apparent role for outcome of treatment. |
| Databáze: | OpenAIRE |
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