Surgery in non-small cell lung cancer of the superior sulcus: results of a combined preoperative and postoperative irradiation regime

Zentralblatt für Chirurgie
J PfannschmidtH Dienemann

Abstract

Due to local invasion of the chest wall, patients with non small cell carcinoma (NSCLC) of the superior sulcus have been treated mainly by the Paulson regime with radiotherapy followed by surgical resection. Recent published data on the use of concurrent irradiation and chemotherapy followed by surgical resection seemed very promising. The aim of the present study was to determine the value and benefit of a combined preoperative and postoperative radiotherapy regime (Sandwich irradiation), and which factors predict prognosis following resection. Between 1986 and 2003, 64 patients with non-small cell carcinoma of the superior sulcus were managed in our department. 28 underwent surgical resection with combined preoperative 40 Gy and postoperative 20 Gy external beam radiotherapy. Time to death was calculated using the method of Kaplan and Meier. Survival after surgery was the end point of the study. The association of factors to end of life end points was analyzed using the log-rank test for univariate analysis. Median follow up was 13.1 months. The actuarial 5-year-survival for the overall population was 30.2 %. For surgically-rendered complete resection (CR) patients with no mediastinal lymph node metastases, the 5-year-surviva...Continue Reading

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