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Background and Purpose: Up to now, evidence about survival of patients with non-small-cell lung cancer treated with radiation therapy alone is only available from clinical studies. The authors analyzed survival experience depending on several prognostic factors from a population-based cancer registry and compared this to survival data from the literature. Patients and Methods: Between April 1996 and September 1999, 1,696 patients with lung cancer were recruited by the Halle Lung Cancer (HALLUCA) Study. 1,183 patients were diagnosed as having non-small-cell lung cancer, and 188 in clinical stages I–IIIb (15.9%) were treated with radiation therapy alone. Results: The median survival time of all patients was 10.2 months, the 2-year overall survival rate amounted to 15.8%. Besides tumor stage, radiation dose was found to be a statistically significant prognostic factor for survival in univariate analysis. The median survival time was 4.2 months for 66 patients treated with < 50 Gy, 10.7 months for 80 patients treated with 50 to < 60 Gy, and 18.9 months for 42 patients treated with ≥ 60 Gy; the corresponding 2-year overall survival rates were 8.7%, 13.4%, und 35.2%. The significant influence of dose persisted even after adjustment for different confounders in a Cox regression model. Conclusion: Patients treated with 50 to < 60 Gy under a potentially curative therapeutic regimen had a significantly lower survival, compared to patients treated with ≥ 60 Gy. In terms of quality assurance, the large proportion of patients treated with radiation doses below the curative range of ≥ 60 Gy was unexpected. [ABSTRACT FROM AUTHOR]

Zusammenfassung Grundgedanke des 1972 eingeführten Verfahrens zur Früherfassung berufsbedingter Hauterkrankungen, des "Hautarztverfahrens", war es, hauterkrankten Beschäftigten einen Berufsverbleib durch 1. Ausschöpfung aller zur Verfügung stehenden berufsdermatologischen Interventionsmaßnahmen und 2. adäquate Therapie zu ermöglichen. Das Hautarztverfahren stellt bis heute das für die Berufsdermatologie wichtigste sekundärpräventive Instrument in der gesetzlichen Unfallversicherung dar. Auf Anregung des HVBG und mit Beteiligung der ABD und des BVDD hatte sich 1999 eine Arbeitsgruppe konstituiert, um das bisherige, "klassische" Hautarztverfahren zu optimieren. Im Vordergrund stand dabei das Bemühen um eine Effizienzsteigerung des Verfahrens. Eine hierzu im Oktober 2002 angelaufene Pilotstudie soll die bessere Umsetzung sekundärer Präventionsmaßnahmen durch das "optimierte" gegenüber dem "klassischen" Hautarztverfahren belegen. Es ist das Ziel, aus den Studienergebnissen einen konkreten Vorschlag für die Gestaltung des "optimierten" Hautarztverfahrens vor seiner bundesweiten Einführung abzuleiten. Abstract The dermatologist's procedure was introduced in 1972 by employers' liability insurance funds in the industrial, agricultural and public sectors of Germany's statutory occupational accident insurance as a "procedure for early detection of occupational skin diseases". So far, it is still the most relevant tool for secondary prevention in occupational dermatology in Germany. According to the intention of this procedure, insured persons with a skin disease in which an occupational aetiology is suspected must be offered preventive measures and, if necessary, given appropriate treatment to avoid their losing their jobs. On the initiative of the Central Federation of Industrial Professional Associations (HVBG), a study group was set up in 1999 from among its membership in cooperation with the Working Committee of Occupational and Environmental Dermatology (ABD) and the Professional Organisation of German Dermatologists (BVDD) to improve on the efficiency of the "classic" dermatologist's procedure. The proposed "optimised" dermatologist's procedure is based on the assumption that early detection followed by competent and intensified skin protection and skin care will be successful in retarding or stopping the progression of occupational dermatoses, while later treatment is likely to be less effective. In October 2002, a pilot study started in Northwest Germany to establish by scientific evaluation whether the implementation of secondary protective measures is definitively better when the provisional "optimised" dermatologist's procedure is followed. The study results should allow detailed suggestions for an improved dermatologist's procedure before it is introduced nationwide. [ABSTRACT FROM AUTHOR]