Is preoperative or postoperative radiation therapy indicated in non-small cell cancer of the lung?
Induction radiotherapy has no routine indication in the treatment of non-small cell cancer of the lung. No survival benefit has ever been shown in a properly conducted trial. Rarely it might be used prior to attempted complete resection of a tumour in close association with a vital organ, in the hopes of minimising damage to that organ. In combination with chemotherapy, irradiation may eventually find a role within an effective induction regimen, particularly in IIIA disease. Post-operative irradiation will reduce local-regional relapse rates in completely resected disease, but there is no demonstrable survival benefit. In incompletely resected disease, usually more advanced initially, there may be a similar effect, of smaller magnitude. However such patients are usually at greater risk from systemic relapse. The availability of radiotherapy should not encourage surgeons to use anything less than meticulous and consistent selection procedures; patients who are technically unresectable should be submitted for experimental protocols, or standard treatment with exclusive radiotherapy.
Payne
D G
DG
Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Canada.
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D015337:Multicenter Studies as Topic; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011182:Postoperative Care; D011300:Preoperative Care; D016032:Randomized Controlled Trials as Topic
D000970:Antineoplastic Agents