Reassessment of the role of postoperative radiation therapy in resected lung cancer.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to N C Choi.
Explore the source record for details and available documents.
From 1972 to 1977, 162 patients were treated with definitive radiotherapy for the underlying unresectable non-small-cell bronchogenic carcinoma by a radiotherapeutic technique that had sequentially evolved from a low-dose (40-45 gray) small-volume approach (AP-PA POP) to a high-dose (60-64 gray) large-volume en-bloc approach (AP-PA POP plus AP-RPO-LPO) which included the primary tumor and the entire regional lymphatics including both supraclavicular areas. Median survival and short-term survival up to 1.5 years were independent of radiation doses (40-64 gray) and target volumes studies. However, long-term survival greater than or equal to 2 years was radiation-dose and target-volume dependent: actuarial survival 36% and 28% vs. 10% and 3% for the high-dose (60-64 gray) en-bloc approach vs. low-dose (40-45 gray) small-volume radiotherapy at 2 and 3 years, respectively, with a minimum follow-up of 2 years, P less than 0.05. Actuarial five-year survival rate 7.5% was obtained with radiation dose greater than or equal to 50 gray. However, there was no five-year survivor among patients who were treated with radiation dose less than 50 gray. Local tumor control is radiation-dose dependent: local tumor control rates at greater than or equal to 18 months were 76% vs. 29% by 56-64 gray vs. 40-49 gray, respectively, P less than 0.05. The patterns of failure appeared to be tumor-histology dependent; for squamous cell carcinoma, the primary and regional lymphatic areas are the most common sites of failure, and for adenocarcinoma, it is the brain or bone. The high-dose en-bloc radiotherapy has been very well tolerated; 5% (4/80) incidence of symptomatic pneumonitis has been observed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.