HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Sudip Ghosh Christos Alexiou David Beggs Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ghosh, S. Articles by Beggs, D. Search for Related Content PubMed PubMed Citation Articles by Ghosh, S. Articles by Beggs, D. Related Collections Lung - cancer

Eur J Cardiothorac Surg 2003;24:1002-1007
© 2003 Elsevier Science NL

Long term results of surgery versus continuous hyperfractionated accelerated radiotherapy (CHART) in patients aged >70 years with stage 1 non-small cell lung cancer

Department of Cardiothoracic Surgery, Nottingham City Hospital NHS Trust, Hucknall Road, Nottingham NG5 1PB, England, UK

Received 11 June 2003; received in revised form 19 July 2003; accepted 23 July 2003.

^* Corresponding author. Fax: +44-116-2709664
e-mail: sudip.ghosh{at}talk21.com

Background: Patients with T1N0 non-small cell lung cancer (NSCLC) are preferably treated by anatomic lobectomy. However, not all such patients are suitable for lobectomy due to their age or co-morbidity. Our aim was to determine the results obtained following lobectomy, wedge resection (WR) or continuous hyperfractionated accelerated radiotherapy (CHART) in patients aged >70 years. Patients: Two hundred and fifteen consecutive patients aged >70 years, with pathologic stage 1 NSCLC in our unit between 1991 and 2001 were studied. Of these patients, 149 had a lobectomy, 47 had a WR and 19 had CHART. Follow-up was 100% complete. Results: Analysis demonstrated the WR and CHART patients to have reduced pulmonary function (FEV₁ 59% and 52%, respectively, of predicted vs. 76%, P<0.001) when compared to the lobectomy group but there were no differences among the groups with regard to mean age and histologic tumour type. There were no operative mortality among patients after WR; however, a 2.7% 30-day operative mortality among patients undergoing lobectomy (P=0.29). Kaplan–Meier survival curves at 1 and 5 years for patients undergoing WR, lobectomy and CHART was 98% and 74% vs. 97% and 68% vs. 80% and 39%, respectively (P=0.0484). The frequency of local/regional recurrence in the WR group (19.1%) was not significantly higher than in the lobectomy group (18.4%, P=0.38) when compared to the CHART group (27%, P=0.07). Conclusion: Loco-regional recurrence and survival after WR and lobectomy in elderly patients with stage I NSCLC are comparable. Although the numbers are small, these data suggest that CHART is a reasonable treatment option for those who are not suitable candidates for surgery.

Key Words: Non-small cell lung cancer • Surgery • Radiotherapy • Continuous hyperfractionated accelerated radiotherapy