• Feng-Ming Kong, Randall K Ten Haken, Matthew J Schipper, Molly A Sullivan, Ming Chen, Carlos Lopez, Gregory P Kalemkerian, and James A Hayman.
• Department of Radiation Oncology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA. Fengkong@med.umich.edu
• Int. J. Radiat. Oncol. Biol. Phys. 2005 Oct 1; 63 (2): 324-33.

PurposeTo determine whether high-dose radiation leads to improved outcomes in patients with non-small-cell lung cancer (NSCLC).Methods And MaterialsThis analysis included 106 patients with newly diagnosed or recurrent Stages I-III NSCLC, treated with 63-103 Gy in 2.1-Gy fractions, using three-dimensional conformal radiation therapy (3D-CRT) per a dose escalation trial. Targets included the primary tumor and any lymph nodes > or =1 cm, without intentionally including negative nodal regions. Nineteen percent of patients (20/106) received neoadjuvant chemotherapy. Patient, tumor, and treatment factors were evaluated for association with outcomes. Estimated median follow-up was 8.5 years.ResultsMedian survival was 19 months, and 5-year overall survival (OS) was 13%. Multivariate analysis revealed weight loss (p = 0.011) and radiation dose (p = 0.0006) were significant predictors for OS. The 5-year OS was 4%, 22%, and 28% for patients receiving 63-69, 74-84, and 92-103 Gy, respectively. Although presence of nodal disease was negatively associated with locoregional control under univariate analysis, radiation dose was the only significant predictor when multiple variables were included (p = 0.015). The 5-year control rate was 12%, 35%, and 49% for 63-69, 74-84, and 92-103 Gy, respectively.ConclusionsHigher dose radiation is associated with improved outcomes in patients with NSCLC treated in the range of 63-103 Gy.

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