非小細胞性肺癌의 放射線治療 成績

Treatment of Unresectable Non-Small-Cell Lung Cancer with Curative Radiotherapy

From 1979 to 1982, 80 patients with unresectable non-small-cell lung cancer without metastasis were treated with high-dose radiotherapy to the primary and to regional lymph nodes with or without supraclavicular lymphatics in the Department of Therapeutic Radiology, Seoul National University Hospital. Of these, 56 patients(70%) were completely evaluable and 59 patients(74%) had squamous cell carcinoma, 13% large cell undifferentiated carcinoma and 8% adenocarcinoma, 21 patients(26%) had StageⅡ and 59 patients(74%) had Stage Ⅲ. The complete and parial response rate in the high-dose(≈6,000 rad) radiotherapy was 70% with 19% complete response, 69 patients(86%) failed in the treatment, by the failure pattern, 64% had local failure alone, 35% had local failure and distant metastasis and 1% had distant metastasis alone. The failure rate in the thorax were 76% in squamous cell carcinoma, 40% in adenocarcinoma and 20% in large cell undifferentiated carcinoma. Preliminary result shows that actuarial survival at 1, 2 and 3 years were 56%, 26% and 20% in overall patients and 64%, 37% and 21% in StageⅡ and 54%, 21% and 18% in StageⅢ, respectively. Overall median survival was 14 months; 17 months in StageⅡ and 13 months in StageⅢ. 8 patients(10%) have lived a minimum of 2 years with no evidence of disease. There was no fatal complication confirmed to be induced by radiotherapy, so definitive high-dose radiotherapy was tolerated well without major problems and resulted in good local control and survival.