Curative radiotherapy of early operable non-small cell lung cancer

Zhang, Hong Xing; Yin, Wei; Zhang, Li Jun; Yang, Zhilin; Zhang, Zhi Man; Wang, Mei; Chen, Dong Fu; Gu, Xianfeng

doi:10.1016/0167-8140(89)90052-2

Cited by 135 publications

(31 citation statements)

References 8 publications

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“…17,[19][20][21] No significant difference in local control rate according to higher dose was noted in our data. However, concerning long-term survival, patients treated with a higher dose (Ͼ65 Gy) had a 5-year survival rate that was superior to the rate in those treated with a smaller dose (Ͻ65 Gy).…”

Section: Discussioncontrasting

confidence: 67%

Radiotherapy for stage I-II non-small cell lung cancer

Okamoto¹,

Murakami²,

Mizutani³

et al. 1999

International Journal of Clinical Oncology

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Background. Surgery has been regarded as the standard treatment for patients with non-small cell lung cancer in the early stage, while radiotherapy has become an effective alternative for medically inoperable patients and those who refuse surgery. Methods. We reviewed the records of 31 patients with stage I-II non-small cell lung cancer treated by radiotherapy between 1980 and 1997. There were 15 patients in stage I and 16 in stage II. The variables analyzed for influence on causespecific survival and loco-regional control were: age, performance status, clinical stage, tumor size, tumor site, radiation field, radiation dose, and combination with chemotherapy. Results. The overall and cause-specific 1-, 2-, 3-, and 5-years survival rates were 71% and 77%; 63% and 73%; 34% and 48%; and 17% and 32%, respectively. Five-year survival rate for patients with peripheral tumor in the lung was 72%, with 70% loco-regional control, while the 5-year survival rate of patients whose tumor originated in the central region was 20%, with 25% loco-regional control. These differences had marginal significance on univariate analysis (P ϭ 0.07), but only tumor site (central vs peripheral ) showed marginal significant influence on cause-specific survival (P ϭ 0.08) and loco-regional control (P ϭ 0.07) on multivariate analysis. There were no fatal complications, including radiation-induced myelopathy. Conclusion. The present series showed satisfactory results with definitive radiotherapy for patients with medically inoperable stage I-II non-small cell lung cancer, with results similar to those in recent reports of radiotherapy. The only significant variable was that patients with peripheral tumors had a better prognosis than patients with central tumors.

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Section: Discussioncontrasting

confidence: 67%

Radiotherapy for stage I-II non-small cell lung cancer

Okamoto¹,

Murakami²,

Mizutani³

et al. 1999

International Journal of Clinical Oncology

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“…Although some studies suggested better survival rates with increasing doses of radiation (10,14,20), others did not (7,11). Some studies showed that histologic type (22) and initial response to radiation (12) were associated with improved patient survival. None of the studies however, included an untreated control group.…”

Section: Discussionmentioning

confidence: 99%

“…Several retrospective analyses have reported the outcomes of patients treated with RT alone but did not include a control group (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). These studies showed that the prognosis of these patients is poor, with a 20% (range 13-39%) 5-year lung cancer-specific survival rate.…”

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confidence: 99%

Effectiveness of Radiation Therapy for Elderly Patients with Unresected Stage I and II Non–Small Cell Lung Cancer

Wisnivesky

Halm

Bonomi

et al. 2010

Am J Respir Crit Care Med

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Rationale: Radiotherapy (RT) is considered the standard treatment for patients with stage I or II non-small lung cancer who are not surgical candidates because of comorbities or preferences against surgery. Objectives: To compare the outcomes of patients treated with RT alone with those who were untreated to assess the effect of RT on survival. Methods: Using the Surveillance, Epidemiology and End Results (SEER) registry linked to Medicare files, we identified 6,065 unresected patients with histologically confirmed stage I and stage II non-small cell lung cancer, diagnosed between 1992 and 2002. We used propensity score methods and instrumental variable analysis to control for the possible effects of known as well as unmeasured confounders. Measurements and Main Results: Overall, 59% of patients received RT. The overall and lung cancer-specific survival of unresected patients treated with RT was significantly better compared with the untreated cases (P , 0.0001 for both comparisons). RT was associated with a 6-month improvement in median overall survival. Propensity score analyses showed that RT was associated with improved overall (hazard ratio, 0.74; 95% confidence interval, 0.70-0.78) and lung cancer-specific survival (hazard ratio, 0.73; 95% confidence interval, 0.69-0.78). Instrumental variable analysis also indicated improved outcomes among patients treated with RT. Conclusions: RT improves survival of elderly patients with unresected stage I or II lung cancer. These results should be confirmed in prospective trials.

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“…radiotherapy is considered the modality of choice (11)(12)(13). However, conventional radiotherapy can cause damage to the lung and adjacent structures producing unwanted adverse effects such as radiation pneumonitis or esophagitis that sometimes lead to a worse performance of patients (2-7).…”

Section: ------------------------------------------------------------mentioning

confidence: 99%

Treatment of stage I non-small cell lung cancer with CyberKnife, image-guided robotic stereotactic radiosurgery

Lee¹

2009

Oncol Rep

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Curative radiotherapy of early operable non-small cell lung cancer

Cited by 135 publications

References 8 publications

Radiotherapy for stage I-II non-small cell lung cancer

Radiotherapy for stage I-II non-small cell lung cancer

Effectiveness of Radiation Therapy for Elderly Patients with Unresected Stage I and II Non–Small Cell Lung Cancer

Treatment of stage I non-small cell lung cancer with CyberKnife, image-guided robotic stereotactic radiosurgery

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