From 1969 through 1979, 171 patients with localized but inoperable or unresectable non-
oat-cell carcinoma (
NOCC) of the lung completed high-dose definitive irradiation. One hundred fifteen received continuous course irradiation to 6000-6500 rad at 180-200 rad/day. Fifty-six received split-course irradiation to 5500 rad at 250-300 rad/day, which included a 2-week break. The two groups were similar with respect to all measured variables. There were no differences in the response rates, failure patterns, survival, or complication rates between the two regimens. The 5-year survival was 6%, with 25.8% dying with infield failure alone and 54.7% with
metastases. The incidence of complications was 8.2%, predominantly acute
radiation pneumonitis. A review of the most comparable literature reveals no significant improvement in the cure rate of definitively irradiated
NOCC with increasing
tumor dose, split-course irradiation, or other modifications of radiotherapeutic technique over the past 25 years. The problems of frequent local recurrences and distant
metastases, and the poor response of
NOCC to presently available systemic
therapy, requires that more effective and broadly applicable local and systemic
therapies be developed before substantial improvements in the cure rate of
NOCC can be expected.