Comparison of outcome between clinically staged, unresected superior sulcus tumors and other stage III non‐small cell lung carcinomas treated with radiation therapy alone

Several studies suggest that patients with non‐small cell lung carcinoma (NSCLC) of the superior sulcus fare better after radiation therapy than hose patients with comparable tumors at other thoracic sites. There is limited data on stage‐by‐stagc; comparisons between patients with superior sulcus tumors (SST) and non‐SST (NSST). Thirty patients had SST among 656 patients with American Joint Committee on Cancer clinically staged IIIA (n = 389) and IIB (n ‐= 267) primary NSCLC who received definitive once‐daily radiation therapy. The median patient age, sex ratio, histologic findings, grade, weight loss, and performance status were similar for SST and NSST. Minimum follow‐up was 24 months, with 88% of patients followed until death. The survival of patients with SST (median, 10.3 months) was similar to that of patients with tumors at other pulmonary sites (median, 10.8 months; P = 0.39). Survival for favorable patients with performance status 0 to 1 and weight loss of 5% or less was comparable between patients with SST (median, 15.0 months) and NSST f. (median, 12.0 months; P = 0.32). Local failure patterns E were similar for patients with SST and NSST (P = 0.48). The brain was the site of first failure in 20% of patients with SST and 10% of patients with NSCLC at other sites JT (P = 0.10). The lack of apparent difference in outcome of compara‐% bly staged patients with SST and NSST treated with radiation alone may have significant therapeutic implications.