Prognostic factors in locoregional non-small cell lung cancer treated with radiotherapy

By means of a retrospective study an evaluation was made of prognostic factors on survival in patients with inoperable locoregional non-small cell lung cancer. The study was performed on a group of 239 patients with a median age of 69 years, 225 men, and 14 women. Patients were treated with external radiotherapy without (184) or with (55) chemotherapy. They received either continuous-course radiotherapy (5,500 cGy in 27-28 fractions and 5.5 weeks) or split-course radiotherapy (1 series of 3,000 cGy, 2 series of respectively 3,000 cGy and 2,500 cGy, or 3 series of, respectively 3,000 cGy, 2,500 cGy, and 2,000 cGy; each series in 10 fractions and 2 weeks, separated by a 4-week interval). Univariate analysis was done by life-table analysis and log-rank test, multivariate analysis by the Cox Proportional Hazards model. The overall survival at 1, 2, and 3 years was 36%, 11%, and 4%. Survival was not significantly influenced by localization of the tumor, grading, distance to the carina, growth pattern, diameter, partial or total atelectasis, lymph node invasion or stage. No significant difference in survival was found between patients who received only radiotherapy and those treated with a combination of radiotherapy and chemotherapy. Univariate analysis showed significant better survival in patients with squamous cell epithelioma, patients without pleural effusion, patients younger than 75 years and patients receiving higher radiation doses. Multivariate analysis showed dose of radiation (P < .001) and pleural effusion (P = .03) to be independent prognostic factors.