[Curative radiotherapy of unresectable bronchial cancer. Apropos of 266 cases without metastasis with 4 to 6 years follow-up (oat cell carcinoma excluded)].
Two hundred and sixty-six patients with inoperable bronchial carcinomas (oat cell excluded) without apparent metastases were treated with curative doses of radiotherapy. The malignancies were: 72% epidermoid epitheliomas, 11.5% adenocarcinomas, 10% large anaplastic cells and 6.5% without histology. According to the TNM classification, 3.5% were T1, 44% were T2 and 52% were T3. Mediastinal invasion was found in 44% of the cases. The mean age of the patients was 65 years (range 31-90 years). The Karnofsky index was less than or equal to 70 in 40% of the subjects. Unoperability was linked to the extent of local involvement in 59% of the cases and to age, general condition or an insufficient forced expiratory volume in 55% of the patients. Sixty to 65 Gy were administered, either classically fractionated or hypofractionated. After irradiation, 43% of the subjects underwent complete radiological remissions. Fifty-five percent of the patients died with local tumor evolution, 40% with isolated local evolution without associated metastases. The overall survival rate at 5 years was 7%; it was 16% for patients with a normal mediastinum and a Karnofsky index greater than 70 (51 cases); if these parameters were inversed, it was 2.5%. The fractionation protocol, the histological type, the use of chemotherapy (48 cases) did not affect the local control rate nor survival. There were almost no complications with this therapy. Patients frequently experienced functional improvement when curative doses of radiotherapy were applied to all the inoperable, non-metastatic cancers and the percentage of survivors at 5 years was non-negligible.
Baillet
F
F
Centre de Traitement des Tumeurs, Hôpital Necker, Paris.
Maulard
C
C
Dessard-Diana
B
B
Manoux
D
D
Housset
M
M
Alapetite
C
C
Michel-Langlet
P
P
Delanian
S
S
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001984:Bronchial Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D011879:Radiotherapy Dosage
Radiothérapie à visée curative du cancer bronchique inopérable. A propos de 266 cas non métastasés d'emblée, avec délais d'observation de 4 à 10 ans (anaplasiques à petites cellules exclus).