Treatment results of non-resectable lung cancer: Radiation alone versus combined radiochemotherapy

Treatment results of non-resectable lung cancer: Radiation alone versus combined radiochemotherapy

91 329 330 ASSESSMENT OF LATE RADIATION DAMAGE IN INOPERABLE BRONCHIAL CARCINOMA PATIENTS TREATED BY PtiICAL RADIOTHERAPY. P.A. Helle, T.K. Gouw, W...

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ASSESSMENT OF LATE RADIATION DAMAGE IN INOPERABLE BRONCHIAL CARCINOMA PATIENTS TREATED BY PtiICAL RADIOTHERAPY. P.A. Helle, T.K. Gouw, W.L.J. van Putten, H. Pilla;, S.;. Tjian, 11. Oudkerk. Dr. Daniel den Hoed Cancer Center, Rotterdan, The Netherlands. Radiation dama8o was assessed with CT-scan densitometrl, ventilation perfusion scans (V-P scans), spirometry and chest ::-ra;rs at 3-monthly intervals. A comparison of these methods will be presented for 69 pts. Prior to each irradiation a CT-scan was made in treatment position. There are 2 re8ions of interest: 1. the hi8h-dose area (isodose >90%) of the irradiated lung outside the tumor; / the region outside the tar8et volume (isodose
ENDOBRONCHIAL RADIOTHERAPY AS PALLIATION IN PATIENTS WITH CENTRAL AIRWAY MALIGNANCIES. P.A. Helle, R. Slingerland, M.J.C. van der Sangen, M. Heysteeg, P.C. Levendag, P.C.M. Koper. Dr. Daniel den Hoed Cancer Center, Rotterdam, The Netherlands. Twenty-five patients with endobronchial tumor were treated by low-dose rate (LDR) or hieh-dose rate (HDR) brachytherapy. Twenty-one patients were pretreated by high-dose external beam radiotherapy. The LDR patients were hospitalized for 1 day, and received lo-15 Gy TD/dose rate 0.9-Z Gy/hour during the night. The HDR patients were treated as outpatients. Twenty-three patients had a bronchial carcinoma (recurrence); 2 patients had a breast cancer recurrence. Six weeks after treatment patients were evaluated bronchoscopically. Fifty-two percent had an endoscopic tumor response; 26% had no response. Twenty-two percent were difficult to evaluate. Progressive disease was found in 1 patient. In 69% the symptoms improved significantly; 12% no chan8e; 19% impossible to assess. The median survival was 3.6 months (2-10 months). In this patient group the median duration of response was 2 months (O-4). In the patients still alive (1-15 months) the response duration is + 3 months (2-9). No treatmentrelated toxicity was found so far. One patient had a fatal bleeding probably due to tumor necrosis. Conclusion: Endobronchial radiotherapy is an excellent palliative technique for recurrent tumors.

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Treatment Results of Non-resectable Lung Cancer: Radiation alone versus Combined Radiochemotherapy. Y.Seino, J.Watarai, M.Kobayashi, I.Mayama, T. Kato Department of Radiology, Akita University Hosp. Japan

Ga-67 Scintinraphy for Detection of Recurrent Lung Y. Nakayama, K. Hayakawa, N. Mitsuhashi, M. Tsuchiya, and H. Niibe Department of Radiology, Gunma University School of Medicine, Showa-Machi, Maebashi, Gunma 371. JAPAN

Materials and Methods The treatment results of 152 non-resectable lung cancer seen from June 1975 to April 1988 were analysed. In the first half of this period, patients were treated with radiation alone, whereas in the latter half of the period, chemotherapy was combined with radiation. Median survival times(MST;months) for the whole patients according to the stage(UICC'87) were stage I(n=12)28M, stagelI(n=16)18M, stageJiIA(n=58) 8M, stagelUB(n=46)6M and stage IV(n=20)4M, respectively. In this report, the value of combined chemotherapy with radiation was evaluated. Results The effect of combined radiochemotherapy was quite evident in small cell lung cancer(SCLC). The MST of radiation alone group(n=ll)was 5M, whereas the MST of radiochemotherapy group(n=14)was 12M(p<0.05). In non-small cell lung ca(NSCLC), the effect of radiochemotherapy was recognized only in stageIUA,ICCB. The MST of radiation alone group(n=50)was 6M, whereas the MST of radiochemotherapy group(n=38)was gM(p(0.05). The time lapse from the start of the therapy to the occurrence of distant metastasis was longer in radiochemotherapy group than in radiation alone group(p<0.05). Conclusions In this historical retrospective study, the value of combined radiochemotherapy was evident in SCLC and stagelIIA,lJIB-NSCLC.But the dosage, combination of agents and timing of chemotherapy were varied case by case, moreaggressive chemotherapy is now being conducted.

Recurrent lesion is not always distinguished from radiation fibrosis using imaging modalities such as chest radiography, X-ray CT, sointigraphy, MRI in lung cancer patients following radiotherapy. For some patients, palliative irradiation for loco-regional reourrence prolonged survival. Ga-67 scintigraphy for detection of recurrent lung cancer following radiotherapy was evaluated on this study. During the period following 382 patients with primary lung cancer treated in our clinic from 1919 to 1987, recurrence was diagnosed retrospectively in 32 patients olinico-pathologically. A positive detection was defined as increased radioactive accumulation in a part of radiation fibrosis. Positive detection was achieved in 9 of 32 patients(28$). And these 9 patients were reirradiated with limited field, and one of them lived over 5 years. Using Ga-67 sointigraphy for deteotion of recurrent lung oanoer following radiotherapy, effective reirradiation is expected.