Postoperative radiotherapy after pneumonectomy: impact of modern treatment facilities.
OBJECTIVE
The present study was undertaken to see how modern treatment facilities, computed tomography (CT)-based treatment planning and linear accelerator, have modified the results of postoperative irradiation after a pneumonectomy for lung cancer.


METHODS
Between 1970-1985, 103 patients were treated in our department after a pneumonectomy: 50 patients with a T1T2N0 tumor and 53 patients with a T3, N1 or N2 tumor. Three groups were considered: 27 patients had only surgical resection, 51 patients were irradiated postoperatively with a Co60 source, and 25 patients were treated using those modern facilities.


RESULTS
The 5-year survival varies from 4% to 31% according to the tumor extent but also to the radiation technique. Patients treated with a Co60 source had a dismal 5-year survival rate (8%) whereas patients treated with the modern facilities had a 5-year survival rate of 30% similar to the 31% of the control surgical group including less advanced tumors.


CONCLUSIONS
Linear accelerator and computed tomography-based treatment planning improved the accuracy of postoperative thoracic irradiation and allow to deliver high doses to the mediastinum even after a pneumonectomy.
Phlips
P
P
Department of Radiation Oncology, Institut Jules Bordet, Brussels, Belgium.
Rocmans
P
P
Vanderhoeft
P
P
Van Houtte
P
P
D003131:Combined Modality Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D011013:Pneumonectomy; D011878:Radiotherapy / Q000009:adverse effects; D015996:Survival Rate; D014057:Tomography, X-Ray Computed