Limited operation for lung cancer in combination with postoperative radiation therapy.
OBJECTIVE
Combination therapy of lung wedge resection and postoperative radiation was performed to confirm the procedure's feasibility as a curative therapeutic modality.


METHODS
Among the patients with clinical stage I lung cancer, who could not undergo a standard lobectomy due to their poor pulmonary function, six cases were studied, who agreed with the experimental trial after the informed consent. One patient of clinical N0 with chest wall invasion (T3) was also included in combination with intraoperative chest wall radiation therapy. At first, a wedge lung resection was performed using an auto-suture technique or manual suturing. Two weeks after the surgery, concomitant radiation therapy of the area including the remnant lung around the cancer and the hilum was initiated. Total dose was 40-50 Gy. All of the patients were followed up for more than five years.


RESULTS
All cases tolerated the procedure and survived more than five years. Six were cancer-free. Cancer recurred in only one case. Its manifestation was pleuritis carcinomatosa. Pleural dissemination, which was undetectable at the time of operation, was presumed to be the cause of the recurrence.


CONCLUSIONS
This procedure was tolerated and feasible, preventing local recurrence following the limited surgery.
Kaneda
Masanori
M
Department of Thoracic Surgery, NHO Mie Chuo Medical Center, Tsu, Mie, Japan.
Watanabe
Fumiaki
F
Tarukawa
Tomohito
T
Tokui
Toshiya
T
Sakai
Takashi
T
D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D010865:Pilot Projects; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D011013:Pneumonectomy; D011184:Postoperative Period; D013902:Radiography, Thoracic; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis; D013536:Suture Techniques; D016896:Treatment Outcome