Limited field irradiation in early stage (T1-2N0) non-small cell lung cancer

Background and purpose: Radiotherapy can effectively control non-small cell lung cancers (NSCLC) of limited size. This study is conducted to investigate whether limited field irradiation, without irradiation of regional lymph nodes, can safely be used in these patients. Materials and methods: Between 1988 and 1993, 31 patients with operable T1-2N0 NSCLC received radiotherapy (48 Gy in 12 fractions) to a limited ('postage stamp') field. The hilum and mediastinum were not included in the radiation portals. Results: Overall survival was 42% at 3 years. Disease-specific survival at 3 years was 76%. One patient developed an isolated regional failure, one had a combined local and distant failure, one had a combined local, regional and distant failure, while three patients failed at distant sites only. Thus, only two patients (6%) recurred regionally. Conclusions: This study shows that 'postage stamp' irradiation is an effective alternative to sugery. Radiation of the hilar and mediastinal lymph nodes can be omitted in these pulmonary compromised patients.