The long-term outcome after radical radiotherapy for advanced localized non-small cell carcinoma of the lung.

The incidence of locoregional failure, distant metastases and intercurrent disease was observed in 76 patients with advanced localized non-small cell lung cancer (NSCLC) entered into a pilot study of CHART. Patients were treated between January 1985 and March 1990 and have a median follow-up of 62 months. All patients had advanced, apparently localized, NSCLC and 76% were considered to show mediastinal involvement. Serial computed tomographic (CT) scans were used to assess patients' response to treatment, allowing us to determine the contribution of locoregional disease to death. Locoregional control was achieved in 32 (42%) of the 76 patients, with the figure falling to 23% at 2 years. Metastatic disease was demonstrated in 44 patients and, once detected, the median survival time was 3.8 months. Overall median survival for the group was 12.8 months, with patients attaining locoregional control faring better, with a median survival of 27.9 months compared with 9.9 months for those who did not achieve locoregional control. The life-tables show a 52% survival probability at 1 year for the whole group, but those attaining locoregional control showed a 75% survival probability compared with 39% for patients failing to achieve complete regression; these figures fell to 62% and 6% respectively at 2 years. To date, six patients remain alive and without evidence of disease at any site, and death has occurred in 12 without evidence of locoregional disease. The remaining 58 patients died with locoregional disease, with 35 also showing evidence of distant metastases.(ABSTRACT TRUNCATED AT 250 WORDS)