Basis for new strategies in postoperative radiotherapy of bronchogenic carcinoma

Conference · Tue Jan 01 00:00:00 EST 1980 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

OSTI ID:5370563

Choi, N C.H.; Grillo, H C; Gardiello, M; Scannel, J G; Wilkins, Jr, E W

In order to improve our understanding of the role of postoperative radiotherapy and to search for new strategies in the management of N/sub 1/, N/sub 2/, T/sub 3/ stage carcinoma of the lung, we analyzed results of treatment in 148 of 166 patients who were registered at the Massachusetts General Hospital Tumor Registry from 1971 to 1977 with a pathological diagnosis of N/sub 1/, N/sub 2/, T/sub 3/ carcinoma of the lung after pulmonary resection. Ninety-three patients received postoperative radiotherapy and another 55 were followed without further treatment. Patients with adenocarcinoma showed significant improvement of survival by postoperative radiotherapy; actuarial NED (no evidence of disease) survival rates were 85% and 51% at 1 year, and 43% and 8% at 5 years for S + RT (patients treated with surgery plus postoperative radiotherapy) and S (patients treated with surgery only) groups, respectively, (P < 0.01). The brain was the most common site of failure in adenocarcinoma, 53% and 58% of all failures occurred in the brain in S and S + RT groups suggesting elective whole brain irradiation in a future trial. For the squamous cell carcinoma group, there was no improved survival in the irradiated patients, actuarial NED survival rates were 63% for both S + RT and S groups at 2 years, and 42% and 33% for S + RT and S groups at 4 years. These figures should be considered in the light of the following: In 52% (24/46) of S + RT vs. 27% (8/29) of S group, disease was in N/sub 2/, T/sub 3/ stages. Regional recurrence was the most common failure in squamous cell carcinoma; 76% (13/17) and 45% (10/22) of all failures were in the regional area in S and S + RT groups. Regional failure in S + RT group was noted with radiation dose up to 5000 rad (TDF 82) which suggests radiation dose higher than 5000 rad in future trial.

• Research Organization: Massachusetts General Hospital, Boston
• OSTI ID: 5370563
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Vol. 6:1; Conference: American Society of Therapeutic Radiologists annual meeting, Los Angeles, CA, USA, 1 Nov 1978
• Country of Publication: United States
• Language: English

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