Radiotherapy for locoregional recurrent tumors after resection of non-small cell lung cancer.

Thirty-two patients with locoregional recurrence without documented distant metastasis after resection of non-small cell lung cancer were treated with radiotherapy. There were 29 male patients and three female patients. The age range was 49-79 years (median 66 years). Twenty patients had squamous cell carcinoma, 11 patients adenocarcinoma and one patient large cell carcinoma. Ten patients had bronchial stump recurrence alone, 14 patients bronchial stump recurrence with mediastinal and/or supraclavicular fossa lymph nodes recurrence, and eight patients mediastinal and/or supraclavicular fossa lymph nodes recurrence without bronchial stump recurrence. The total dose delivered ranged from 47.5 to 65 Gy. We achieved good results on improving on subjective complaints. Eighty-nine percent (17/19) of patients indicated subjective improvement. Eight of 32 (25%) patients showed a complete response, and 13 of 32 (40.6%) patients showed a partial response. Only one of seven patients (14.3%) with less than 60 Gy showed a complete response, but seven of 25 patients (28%) with 60 Gy and more showed a complete response. The survival rate was 56.2% at 1 year and 12.5% at 5 years. Four patients have survived more than 5 years. The survival rate of the patients with complete response was 50% at 3 and 5 years, that of the patients with non-complete was 12.5% at 3 years and 0% at 5 years (Cox-Mantel test, P < 0.05). In conclusion, high-dose radiotherapy for locoregional recurrent tumors after resection was effective for palliation and improved survival.