Purpose: Stereotactic radiotherapy (SRT) is highly effective for brain meta
stases from non-small-cell lung cancers (NSCLCs). As such, primary lesions
of NSCLC may also be treated effectively by similar focal high-dose SRT.
Methods and Materials: Between October 1994 and June 1999, 50 patients with
pathologically proven T1-2N0 MO NSCLC were treated by CT-guided frameless
SRT. Of these, 21 patients were medically inoperable and the remainder were
medically operable but refused surgery. In most patients, SRT was 50-60 Gy
in 5-10 fractions for 1-2 weeks. Eighteen patients also received conventio
nal radiotherapy of 40-60 Gy in 20-33 fractions before SRT.
Results: With a median follow-up period of 36 months (range 22-66), 30 pati
ents were alive and disease free, 3 were alive with disease, 6 had died of
disease, and 11 had died intercurrently. Local progression was not observed
on follow-up CT scans in 47 (94%) of 50 patients. The 3-year overall survi
val rate was 66% in all 50 patients and 86% in the 29 medically operable pa
tients. The 3-year cause-specific survival rate of all 50 patients was 88%.
No definite adverse effects related to SRT were noted, except for 2 patien
ts with a minor bone fracture and 6 patients with temporary pleural pain.
Conclusions: SRT is a very safe and effective treatment for Stage I NSCLC.
Additional studies involving a larger patient population and longer follow-
up periods are warranted to assess this new treatment for early-stage lung
cancer. (C) 2001 Elsevier Science Inc.