title: Trimodality treatment in patients with superior sulcus tumors: hopes and realities.
abstract: OBJECTIVE
  In late 2001 at our institution, we started offering induction radiochemotherapy as a treatment option for superior sulcus tumors. Our aim was to evaluate treatment choices and outcome in this patient group treated over the past 7 years at our institution.
  
  
  METHODS
  The records of 34 patients were retrospectively reviewed and 33 were assessable for the analysis.
  
  
  RESULTS
  Twenty of 28 patients with M0 disease had operable disease. The induction radiochemotherapy for superior sulcus tumors was possible in about two-thirds (14/20) of the cases with operable disease, with only one-third (5/14) of these having undergone surgery. The most common reason for not proceeding to surgery following induction radiochemotherapy was patient refusal (n = 5). The median follow-up of all 33 patients was 17 months. In curatively treated patients with (n = 11) or without surgery (n = 15), the median overall survival time was 26 months (range, 10-26) and 26 months (range, 7-71), respectively ( P = 0.534). Local-regional and/or distant failure developed in 20 of 26 patients treated curatively. In patients treated with the trimodality regimen (n = 5), no local-regional failure was observed, and distant failure occurred in one case.
  
  
  CONCLUSIONS
  The trimodality treatment was possible in 25% of cases with operable disease due to the high rate of patient refusal to proceed to surgery following induction radiochemotherapy. No difference in survival was observed between patients treated with surgery and those treated with radiochemotherapy only because of a limited follow-up. So, the benefit of additional surgery is not clear, and a longer follow-up is needed before final conclusions can be drawn.
authors: Department of Radiation Oncology, Trakya University Hospital, Edirne, Turkey.
authors: Zafer
authors: Z
authors: Kocak
authors: Mert
authors: M
authors: Saynak
authors: Kazim
authors: K
authors: Uygun
authors: Yener
authors: Y
authors: Yoruk
authors: Alaattin
authors: A
authors: Ozen
authors: Necdet
authors: N
authors: Sut
authors: Gundeniz
authors: G
authors: Altiay
authors: Murat
authors: M
authors: Caloglu
authors: Altemur
authors: A
authors: Karamustafaoglu
authors: Ufuk
authors: U
authors: Usta
authors: Hakan
authors: H
authors: Karagol
authors: Osman N
authors: ON
authors: Hatipoglu
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods; D011879:Radiotherapy Dosage; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D005047:Etoposide; D002945:Cisplatin