gms | German Medical Science

Aim: To evaluate local tumour control and overall survival of HSRT as single treatment in primary or secondary NSCLC stage I.

Material and method: From December 2000 to September 2005, 110 pat. with malignant tumours of the lung were treated by HSRT, with 68 pat. of them having a primary or secondary NSCLC stage I (cT1-2 cN0 cM0; median age 76 (59-92) years; pats. functional inoperable due to severe COPD and/or cardial disease; median total radiation dose 37.5 (24–40) Gy in surrounding 60 %-isodose; 3–5 fractions; immobilisation by vacuum coach (Fa. Medical Intelligence); mean follow-up of living pats. 23 (3–48) months). LN- and distant metastases were excluded previously by brain-, thoracic- and abdominal-scan and FDG-PET-scan as well. Follow-up was in 3- to 6-monthly intervals with CT-scan, FDG-PET and/or bronchoscopy if no complete tumour response was seen after 12 months of later.

Results: Local tumour control at 1, 2, 3 and 4 years is 96 %, 86 %, 86 %, and 86 %, respectively, with 5 local recurrences in total, and none of them later than 18 months after HSRT. Disease-specific survival at 1, 2, 3, and 4 years is 94 %, 84 %, 68 %, and 68 %, respectively. 9 pats. died due to lung cancer, with only two of them due to local progression, and 11 pats. died due to comorbidities, that means secondary cancer of rectum, bladder, or head and neck, apoplexy, liver cirrhosis, and others.

Conclusion: HSRT causes a high local tumour control in early stage NSCLC, and should be considered treatment of choice in all inoperable pats.