A single treatement arm, phase I/II trial was performed to determine the tumor response to concomitant boost radiotherapy and to assess the toxic effects of this techneque in patients with stage III NSCLC. Between 1991-1992, 52 patients with stage III NSCLC were treated according to the concomi- tant boost technique. The large fields including primary mass and mediastinum received a dose of 54Gy in 30 daiiy fractions. The boost dose(13 Gy) was administered concomitantly with the last ten fractions of the large fields treatment, with a 6 haur intervaL The maximal allowed dose to the spinal cord was 45 Gy. At a median follow-up of 13 months, complete remission was achieved in 15 patients(28.8%) and a partial remission in 28 aptients(53.8%). The overall survival rate at 2 year was 19.9%. The median survival time was 13 months. The survival rates were 28% and 16% for the complete responders and partial/non responders. Grade 1 and 2 esophagitis occurred in 86.5% and 13.5% of the patients, respectively. The clinical or radiologic condition of 38 patients (73.1%) was compatible with radiation pneumonitis but no patients showed severe symptoms. Late complications have been limited to radiologically detected lung fibrosis in 12(23.1%) patients. The results so far appeared to be better than the outcome of conventional radiotherapy. Its real value will be determined in a prospective randomized study.
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