Impact of the radiation dose and completion of palliative radiotherapy on survival in patients treated for locally advanced lung cancer

Aim: To compare three total radiation dose levels for their impact on survival in patients receiving palliative radiotherapy (RT) for locally advanced lung cancer. Patients and Methods: Radiation dose (equivalent dose in 2 Gy fractions=EQD2: 31-40 Gy vs. 41-46 Gy vs. 47-52 Gy), completion of RT as planned, plus nine factors were analyzed for survival in 125 patients. Results: On multivariate analysis, EQD2 47-52 Gy (p=0.018), completion of planned RT (p=0.002), lower T-category (p=0.027) and lower Ncategory (p=0.008) were positively associated with survival. Thirty-six patients (29%) could not receive the complete planned RT dose, 19% in the 31-40 Gy group, 36% in the 41-46 Gy group and 31% in the 47-52 Gy group, respectively. Six-month survival rates of these patients were 0%, 18% and 18%, respectively. Conclusion: Higher RT doses resulted in significantly better survival than lower doses. The favorable results were impaired when the planned treatment could not be completed.