Researchers affiliated with a Phase II North American multicenter study have reported that sterotactic radiotherapy for Stage TI-II non–small cell lung cancer (NSCLC) results in a three-year survival rate of 56% in medically inoperable patients. The details of this study were published in the March 17, 2010 issue of the Journal of the American Medical Association.[1]

Radiation therapy is the treatment of choice for inoperable patients or patients who refuse surgery for Stage I-II NSCLC. There have been many improvements in the delivery of radiotherapy over the past two decades; these include stereotactic radiation therapy and intensity modulated radiotherapy (IMRT); both techniques deliver more radiation with fewer side effects to healthy cells. In addition, there have been developments in treating Stage I-II NSCLC with photons and carbon ion beam therapy as well as radiofrequency ablation combined with radiation therapy. Researchers from Germany have recently reported that single-dose stereotactic radiotherapy is associated with a 69% 36-month local control rate in patients with Stage I-II NSCLC. Other recent studies have suggested that local control rates achieved by radiotherapy approach those achieved with surgery for patients with Stage I NSCLC. A recent Scandinavian study reported that stereotactic radiotherapy for Stage I NSCLC is associated with a local control rate of 90% in patients deemed medically inoperable. Researchers from Holland have also reported that stereotactic radiotherapy results in a local control rate of 89% in patients with Stage I NSCLC.

The current study included 44 patients with T1 and 11 with T2 NSCLC treated with stereotactic radiotherapy. The median follow-up was 34.4 months.

• The primary three-year local control rate was 90.6%.
• The loco-regional control rate was 87.2%. The three-year distant failure rate was 22.1%.
• The three-year disease-free survival was 48.3%
• The three-year overall survival was 55.8%

Comments: This study confirms the results of previous studies suggesting that stereotactic radiotherapy is effective therapy for Stage I-II NSCLC.

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