Intraoperative radiotherapy (IORT) - alternative treatment in functionally nonresectable nonsmall cell lung cancer (NSCLC)

BACKGROUND: Lung cancer remains a leading cause of cancer death. For limited disease nonsmall cell lung cancer (NSCLC), surgical resection is state-of-the-art. Functional- or anatomic inoperability and poor performance status require alternative treatment. METHODS: A study initiated in 1987 investigates intraoperative radiation therapy (IORT) combined with external beam irradiation (EBI) as therapeutic alternative for patients with NSCLC whose performance status allows thoracotomy but not lobectomy. All of so far 52 patients – 14 females (26.9%), 38 males (73.07%) aged 49 to 80 years (median: 65 years) – underwent IORT carried out by postero-lateral thoracotomy. EBI happened in 50 patients 4 weeks after IORT. RESULTS: With 50 patients completing EBI the actuarial overall survival was 71.2%, 55.8%, 34.6%, the diseases specific one was 76%, 63.2%, 49.5% at 12, 24 and 36 months, respectively. CONCLUSIONS: Combined IORT and EBI represent an efficient, feasible, and well-tolerated treatment option for NSCLC patients ineligible for lung resection.