[Bronchial carcinoma. Problems and treatment with special reference to radiotherapy (author's transl)].
With reference to the recent literature, a representation of case-history, therapy and prognosis of bronchial carcinoma is made. Inhalation of tar products by smoking, as well as predominantly occupational dust are the important etiological factors for the increase in bronchial carcinoma. Because of the long occult progression of the disease the diagnosis based on clinical symptoms is made very late. Only a greater effort in organisation and diagnostics permits an early detection in high-risk groups. Therapeutic success has remained constant since the sixties. Up to now only the consequent pre-operative selection of patients has been significant for improvement of surgical results. Five-year cures are more frequent after lobectomy than after pneumonectomy. In radiation therapy, the use of high-voltage gamma rays in contrast to conventional deep radio-therapy, has not brought any significant improvement. An additional intensive and individual care and follow-up of patients is of vital importance. The optimal curative radiation dose is 6000 rad. Particularly pre-operative irradiation is important to prepare some inoperable patients for curative surgery. Postoperative radiation therapy is also valuable for doubtful radical surgery and after exploratory thoracotomy. Palliative radiation therapy results in rapid disappearance of symptoms; with generalized disease or in suspicion for formation of metastases, chemotherapy should be preferred. This is particularly true for anaplastic, small and large cell carcinomas, and their rapidly growing metastases. In those cases, combination of polychemotherapy may decrease the tumor size and increase the length of remission. The prognosis depends on microscopic tumor type, stage of the disease, and therapy. Abnormal excretion of steroids and immunological disturbances are prognostic at the time of diagnosis.