Comparison of stereotactic techniques of irradiation in aged patients with early stages of non-small cell lung cancer

Abstract

The results of 2 years survival after stereotactic radiation therapy for 117 patients with early-stages of non-small cell lung cancer (NSCLC) in patients with the age-related contraindications to surgery (with heavy cardiovascular diseases) were analyzed. We compare three treatment methods: 3D conformal radiotherapy in the free breathing - 39 patients (group 1); 3D dynamic conformal radiotherapy with active breath control - 42 patients (group 2), and high-hypofractionated stereotactic radiation therapy - 36 patients (3 group). Local control rate was highest in the group 3 - 85 %. Two year survival rate in groups 1, 2 and 3 reached 41%, 56% and 66 %, respectively. It was revealed that the results of high-dose hypofractionated radiation therapy for 2-year survival rates are comparable with surgery. Thus, the distant stereotactic conformal radiation therapy of NSCLC stages 1 and 2 with active breath control showed a higher efficiency without increasing the toxicity on the mediastinum, which has compromised heavy competing cardiovascular diseases. Also, the best long-term results of treatment were registered in a group of high-dose hypofractionated stereotactic radiotherapy.