To retrospectively review the outcomes of patients with non-small cell lung cancer (NSCLC) treated with radical radiotherapy or chemoradiation over a 6-year period in a regional cancer centre.
Patients with newly diagnosed stage I to III NSCLC treated at our centre between 1 January 2010 and 31 December 2015 and received radical radiotherapy or chemoradiation were included. Patients treated with stereotactic body radiotherapy were excluded. Data on patient demographics, tumour characteristics, treatment-details including acute toxicity, local recurrence, distant recurrence and survival were collected and analysed.
Fifty-three patients were treated during the review period. There were 36 (68%) men and 17 (32%) women with a median age of 68 years (range 44 to 93). The median follow-up was 29 months (range 4.7 to 98). The median ECOG performance score was 1. The majority were current or ex-smokers (94%) with a median of 40 pack years. There were 18 patients with stage I or II disease and 35 with stage III disease. Most patients (98%) were staged with a FDG-PET scan. Adenocarcinoma (32%) and squamous cell carcinoma (53%) were the most common histological diagnoses. The median primary tumour diameter was 42 mm (range 17-101mm). The median radiation dose was 60Gy in 30 fractions (range 50 to 66 Gy), and 76% received concurrent chemotherapy. Twenty-seven (51%) patients developed grade 3 or 4 acute toxicity and 29 (55%) patients had an unplanned admission during or within 30 days of radiotherapy. A total of 34 patients recurred (69%), 30 with distant disease and 11 with local failure. The median progression free survival and overall survival were 19.2 and 27.5 months respectively.
Patient outcomes in our study cohort are comparable with the contemporary existing literature. Acute toxicity of treatment is significant and unplanned admissions fairly frequent. Ongoing advances in immunotherapy are likely to bring the next significant improvements in survival for this patient group.