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According to a recent article published in the International Journal of Radiation Oncology, Biology Physics, patients with stage I-II non-small-cell lung cancer who are not candidates for surgery may be effectively treated with radiation therapy alone.

Lung cancer is the leading cause of cancer deaths in the United States. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer and refers to the type of cell within the lung in which the cancer starts. Stages I NSCLC refers to cancer that is isolated in only one lung. Stage II NSCLC refers to cancer that is located in only one lung but may involve lymph nodes on the same side of the chest. Standard treatment for stages I-II NSCLC often involves the surgical removal of the cancer, during which time the extent, or stage, of the cancer is determined. Chemotherapy and/or radiation either before and/or following surgery may also be used in treatment. The role and sequence of delivery of chemotherapy and radiation are still being evaluated.

Many patients with lung cancer are not able to undergo the surgical procedure of removing their cancer. Often, these patients are too elderly or suffer from other medical conditions such as heart disease and their lung capacity may be too diminished to withstand surgery. For these patients, staging of their cancer may be relatively precise using newer scanning techniques, including positron emission tomography (PET) and they are often offered radiation therapy as treatment for their cancer.

Researchers in Germany recently analyzed data from an extensive review of medical literature since the mid-1980’s involving patients with stages I-II NSCLC treated with radiation therapy alone to determine long-term outcomes of these patients. The results indicated that radiation therapy alone produced an average survival time of over 30 months. The survival rate at 5 years following therapy was approximately 30% for patients with stage I NSCLC and 25% for patients with stage II NSCLC. Many patients died from other medical conditions besides lung cancer.

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These researchers concluded that patients with stages I-II NSCLC who are not able to, or do not wish to undergo surgery may be effectively treated with radiation therapy alone. Furthermore, since this data involved patients from the mid 1980s, survival may be improved with the advent of more accurate staging techniques and more advanced radiation delivery processes. Patients with early-stage NSCLC who cannot tolerate surgery may wish to speak with their physician about the risks and benefits of radiation therapy or the participation in a clinical trial evaluating improved radiation therapy or other promising therapies. Two sources of information regarding ongoing clinical trials include the National Cancer Institute ( and also provides personalized clinical trial searches on behalf of patients.

Reference: Jeremic B, Calssen J, Bamberg M. Radiotherapy alone in technically operable, medically inoperable, early-stage (I/II) non-small-cell lung cancer.

International Journal of Radiation Oncology, Biology, Physics. 2002;54:119.

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