Radical radiotherapy in stage I XXXX ( @entity1149 )--Singapore National @entity5 Centre experience.

@entity1 @entity1149 @entity5 @entity18552
INTRODUCTION: The aim of this study was to assess the outcome of radical treatment for stage I @entity1149 ( @entity1149 ) with external beam radiation therapy. MATERIALS AND METHODS: A retrospective series of 23 @entity1 with stage I @entity1149 treated radically with radiotherapy from September 1997 to December 2004 at the National @entity5 Centre, Singapore. Eighteen @entity1 had 3D conformal radiotherapy and 5 @entity1 had 2D planning. The median radiation dose delivered was 55 Gy (range, 50 to 67.5 in 20 to 33 fractions). The estimated median @entity18552 (10) was 63.9 Gy (range, 57.6 to 70.1). Complete response (CR) rates, overall survival and cause-specific survival rates were analysed for evaluation of treatment results. Local regional failure was defined as disease in the ipsilateral lung and entire mediastinum. Recurrence at the contralateral lung and other distal organs was defined as distant metastases. Survival data were calculated using the Kaplan-Meier method and tested for significance with log-rank statistics. RESULTS: A total of 23 @entity1 (16 males, 7 females) with a median age of 73 years (range, 45 to 88) were analysed. Six (26%) had stage IA and 17 (74%) had stage IB disease. Eleven @entity1 refused surgery and 12 @entity1 were medically inoperable. The median follow-up was 18.9 months (range, 6.2 to 117.4). The overall survival at 2 years and 3 years was 54.7% and 24.3% respectively. The overall cause-specific survival was 57.4% at 2 years and 25.6% at 3 years. Radiological CR was obtained in 6/23 @entity1 (26%) and the median survival was 24.8 months as compared to 20 months in @entity1 who attained partial response (PR) or unknown response (P = 0.24). The median survival for 12 @entity1 who received a @entity18552 (10) of > or =63.9Gy was not reached as compared to 20 months in 11 @entity1 with @entity18552 (10) of <63.9 Gy (P = 0.03). Sixteen @entity1 died, 14 due to disease recurrence or progression and 2 of unrelated causes. Seven @entity1 (29.2%) remained alive. The longest surviving @entity1 had a follow-up time of 117.4 months. Four of these 7 @entity1 were disease-free and 3 were alive with disease (2 with bone metastases and 1 with recurrence in the primary site). CONCLUSION: Our data are consistent with the reported literature for stage I @entity1149 treated with radical radiotherapy. @entity1 who received a higher dose of radiation have a better outcome. The 3-year cause-specific survival of 25.6% is less than ideal and further investigations into dose escalation with modern radiotherapy techniques and perhaps the addition of chemotherapy or new targeted agents to radiation are warranted to improve the outcome.
