Radiotherapy alone in elderly patients with medically inoperable stage IIIA and IIIB non-small cell lung cancer

Background: We have analysed our experience with medically inoperable IIIA and IIIB elderly patients (aged greater than or equal to 70 years), treated with radiotherapy alone, to better define the potential benefit of this approach. Materials and Methods: From 1992 to 1995, 41 patients with NSCLC (Non Small Cell Lung Cancer), stage III, aged greater than or equal to 70 years were irradiated with curative intent. Results: Median follow-up was 20 months (range 9-53). The 2 year OS (Overall Survival) and DFS (Disease Free Survival) were respectively 27% and 14.6% for all patients. Patients presenting weight loss >10% experienced 14% OS at 24 months compared to 58% for those without weight loss (p = 0.0027). A 64% OS at 24 months was seen in patients with tumor size less than 4 cm compared to 7% of patients with tumor size > 4 cm (p = 0.0009). Conclusion: Radiotherapy is a good management for locally advanced NSCLC in the elderly patients assuring good quality of life, high rates of relief of symptoms and OS and DFS similar to those obtained with chemotherapy and chemotherapy plus radiotherapy.