P3-192: Radiation therapy alone for unresectable stage III non-small cell lung carcinoma with poor performance

Abstract

Many studies for unresectable stage III non-small cell lung carcinoma (NSCLC) focused on patients with good performance. However, there were few reports for patients with poor performance status. We treated them with split course radiation therapy (RT) alone and evaluated the results. From Jun 1996 to Mar 2004, 80 patients started the split course RT according to our protocol. They were confirmed to have unresectable stage III NSCLC with poor performance; performance scale "d ECOG 2. Initially they received 30 Gy of radiation with 2.5 or 3 Gy per fraction to gross tumor volume (GTV). The tumor response was evaluated 2-3 weeks later. And the second course of RT was recommended for good responders: "d 50% tumor diameter reduction or improved distal atelectasis. The treatment related toxicity was evaluated also. Eleven patients did not finish the initial course of RT (3-27 Gy) due to disease progression or personal reasons. Thirty-eight patients (55.1%) among 69 patients who completed the first course of RT showed a good response. Thirty good responders received the second course of RT with total 51 to 60 Gy. Eight patients of them did not receive the second course of RT due to distant metastasis or poor performance. Two-year survival rate and median survival were 14.7% and 7 months in all patients, and 26.0% and 14 months in 30 good responders who completed the second course of RT, respectively. Five patients (12.8%) from 39 evaluable patients had grade III radiation esophagitis (N=1) or pneumonitis (N=4). RT alone was tolerable modality for unresectable stage III NSCLC with poor performance. In addition, it was able to produce comparable survival results in patients who showed good response after the first course RT and completed the second course of RT compared with patients with good performance.