Radiation therapy for Stage I–III epidermoid carcinoma of the lung

• Published in: Lung cancer Vol. 8; no. 3; pp. 213 - 223
• Main Authors: Hayakawa, Kazushige, Mitsuhashi, Norio, Nakajima, Nobuaki, Saito, Yoshihiro, Mitomo, Osamu, Nakayama, Yuko, Katano, Susumu, Niibe, Hideo
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.10.1992; Elsevier Science
• Subjects: Biological and medical sciences; Diseases of the respiratory system; Epidermoid carcinoma of the lung; Medical sciences; Radiation therapy; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Tolerance dose; Epidermoid carcinoma of the lung; Tolerance dose; Radiation therapy; Human; Treatment; Respiratory disease; Malignant tumor; Radiotherapy; Bronchopulmonary; Spindle cell carcinoma
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/0169-5002(92)90009-9

From 1976 through 1985, 142 patients with Stage I–III epidermoid carcinoma of the lung received radiation therapy (RT) with total doses of 60–80 Gy at Gunma University Hospital. Patients with performance status (PS) 0–1 had an actuarial survival of 47% and 24% at 2 and 5 years, compared with 27% and 7% in those with PS 2, and 10% in PS 3 ( p < 0.01). The actuarial survival rates for stage I, II, IIIA and IIIB were 75%, 44%, 32% and 19% at two years, and 31%, 22%, 13% and 10% at five years, repectively ( p < 0.05). At five years, 26% of the patients with tumors less than 5 cm in diameter had survived, in contrast to 11% in those with tumors greater than 5 cm in diamter ( p < 0.001). Patients given a total dose of 80 Gy or over had a lower long-term survival rate than those given a total dose of 60–79 Gy. Four patients irradiated over 80 Gy at the proximal portion of bronchi developed severe bronchial stenotic changes resulting in pulmonary insufficiency and died of intercurrent pulmonary disease without evidence of recurrence of the carcinoma at one or three years after RT. Patients with the primary tumors located in the upper lobes or the superior segment of the lower lobes had an excellent prognosis ( p < 0.05). Stage N3 disease or malignant effusion revealed unfavorable prognostic factors. For age, sex and histologic subtypes, there were no significant differences in survival. For the five year survivors, the total irradiated doses were 60–70 Gy, and the size of the radiation field given over dose of 40 Gy was mostly 100 cm 2 or less. In our results, the patients with epidermoid carcinoma of the lung without distant metastasis or malignant effusion were expected to be offered a realistic probability of long-term survival by RT alone.