7623 Background: Stereotactic radiotherapy (SRT) has been aggressively performed as a radical treatment for stage I non-small cell lung cancer (NSCLC) in Japan, however most cases were medically inoperable. In a large Japanese multi-institutional experience, we reviewed the treatment outcome of SRT for medically operable stage I NSCLC cases with the patients’ refusal to surgery. Methods: In 1995–2004, 86 medically operable patients with stage I NSCLC (median age, 74 years; 62 T1N0M0; 24 T2N0M0) were treated with SRT alone in 14 reliable institutions. Stereotactic three-dimensional treatment was performed using non-coplanar dynamic arcs or multiple static ports. A total dose of 20 to 72.5 Gy at the isocenter was administered in 1 to 10 fractions. Median calculated biological effective dose (BED) was 115 Gy (range, 100–153 Gy). The data was collected and analyzed in a retrospective manner. Results: During follow-up (median, 43 months), pulmonary complications of above grade 2 arose in 4 patients (5.8%). Local control rates at 3 and 5-year post SRT were 88.1% and 85.5%, respectively. Three and 5-year overall survival rates were 80.7% and 71.3%, respectively. Five-year overall survival rate for patients whose age was over 70 years (n=27) and under 70 years (n=58) were 74.3% and 69.6%, respectively. Five-year overall survival rate for stage IA (n=62) and IB (n=24) cases were 72.3% and 68.4%, respectively. Conclusions: SRT is safe and promising as a radical treatment for operable stage I NSCLC. The survival rate of SRT is potentially comparable to that of surgery. No significant financial relationships to disclose.
Palliative chemotherapy followed by consolidation radiotherapy in patients with advanced and metastatic non-small cell lung cancer not suitable for radical treatment