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J Korean Soc Ther Radiol > Volume 13(1); 1995 > Article
Journal of the Korean Society for Therapeutic Radiology 1995;13(1): 19-26.
Curative Radiation Therapy for T2N0M0
In Kyu Park, Jae Choel Kim
Department of Radiation Oncology, School of Medicine, Kyungpook National University, Taegu, Korea.
Surgery is the treatment of choice for resectabel non-small cell lung cancer. For patients who are medically unable to tolerate a surgical resection or who refuse surgery, radiation therapy is an acceptable alternative. A retrospective analysis of patients with stage I non-small cell lung cancer treated with curative radiation therapy was performed to determine the results of curative radiation therapy and paterns of failure, and to identify factors that may influence survival.
From 1986 through 1993, 39 patients with T2N0M0 non-small cell lung cancer were treated with curative radiation therapy at department of radiation oncology, Kyungpook national university hospital All patients were not candidates for surgical resection because of either patient refusal (16 patients), poor pulmonary function (12 patients), old age (7 patients), poor performance (2 patients) or coexisting medical disease (2 patients). Median age of patients was 67 years. Histologic cell type was squamous cell carcinoma in 1. All patients were treated with megavoltage irradiation and radiation dose raged from 5000cGy to 6150 cGy with a median dose of 600cGy. The median follow-up was 17 months with a range of 4 to 82 months. Survival was measured from the date therapy initiated.
The overall survival rate for entire patients was 40.6% at 2 years and 27.7% at 3years, with a median survival time of 21 months he disease-free survival at 2 and 3 years was 51.7% and 25.8%, respectively. Of evaluable 20 Patients with complete response, 15 Patients were considered to have failed. Of these, 13 patients showed local failure and 2 patients failed distantly. Response to treatment (p=0.0001), tumor size (p=0.0019) and age p=0.0247) were favorably associated with overall survival. Only age was predictive for disease-free survival (p=0.0452).
Radiation therapy is an effective treatment for small (less than 3 cm) tumors, and should be offered as an alternative to surgery in elderly or infirm patients. Since local failure is the prominent patterns of relapse, potential methods to improve local control with radiation therapy are discussed.
Key Words: Non-small cell lung cancer, Stage I, Radiation therapy
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