CT-planned accelerated hypofractionated radiotherapy in the radical treatment of non-small cell lung cancer.

Surgery is the standard treatment for stage I, II and certain stage IIIA non-small cell lung cancers (NSCLC). A proportion of patients with technically operable NSCLC do not undergo surgery because of significant co-morbidity or refusal, and radical radiotherapy may cure some of these patients. Between April 1997 and March 2000, 135 consecutive patients with stage I-IIIB NSCLC were treated with CT-planned accelerated hypofractionated radical radiotherapy to a dose of 50-55Gy in 15-20 fractions over 3-4 weeks at a single centre. The 2-year overall and cause-specific survival for all patients was 44.4% (95% CI = 36.8, 53.7) and 47.8% (95% CI = 39.9, 57.3) respectively. Overall median survival was 21 months (95% 18, 28). There were no reports of severe acute or late treatment-related toxicities. These results compare favourably with previously published studies on radical radiotherapy in NSCLC, suggesting this may be an effective and safe technique.