Exclusive radiotherapy for non-small cell lung cancer. A retrospective multicentric study

Summary Purpose To evaluate the daily practice of management of early inoperable lung cancer (stage I). Materials and methods The analysis was based on a questionnaire which was sent to participated centers. Between 1982 and 1994, 123 patients with an early stage I inoperable lung cancer were treated with definitive irradiation in the different institutions. The survival distributions were estimated by the Kaplan-Meier method. The following covarties were analyzed: age, gender, Karnofsky status, symptoms, diagnostic work-up, T stage, tumour size, tumour location, histology, respiratory and cardiac contra-indication. The univariate analysis was performed using log-rank test. Cox regression models were used to find the independent prognostic factors. Results : The 2 and 5-year survival rates were 34% and 8% respectively. The 5-year local failure rate was 42% for T1 and 82% for T2. In a multivariate analysis, the most important prognostic factors for survival were the performance status and the stage. After adjustment for these two covariates, the total dose delivered had no impact for the range of doses used in this series. Conclusions Our poor data outlined the needs for better radiation technique and for a better staging system.