ABSTRACT
Conducting postoperative radiotherapy in a mode of hypofranctionation with SFD-3Gy to TFD-36-39Gy (EQD2 = 43,246,8Gy) in combined treatment of patients with non-small cell lung cancer allows significantly increasing a 5-year disease-free survival at IIB-IIIB stages of the disease (pN1-2) as well as the central cancer, squamous cell morphological type of tumor after surgery in a volume of lob-bilobectomy. The clearest effect of postoperative radiotherapy is assessed by survival without locoregional recurrence where radiation therapy in the adjuvant setting allows achieving a statistically significant increase in local control of the disease to the level of 85-95% regardless of stage of the disease, tumor size, regional lymph nodes lesion and the surgical treatment.
Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Adult , Aged , Carcinoma, Non-Small-Cell Lung/mortality , Carcinoma, Non-Small-Cell Lung/radiotherapy , Carcinoma, Non-Small-Cell Lung/surgery , Disease-Free Survival , Female , Humans , Lung Neoplasms/mortality , Lung Neoplasms/radiotherapy , Lung Neoplasms/surgery , Male , Middle Aged , Postoperative Care/methods , Survival RateABSTRACT
The review considers the history of evolution and the present state of the problem of postoperative radiotherapy for non-small cell lung cancer. The randomized trials and meta-analyses given in recent publications provide evidence that it should be used in radically operated patients with morphologically verified regional metastases. The paper also shows promises of hypofractionation and a postoperative radiation/chemotherapy ratio for non-small cell lung cancer.
Subject(s)
Carcinoma, Non-Small-Cell Lung/radiotherapy , Lung Neoplasms/radiotherapy , Pneumonectomy , Postoperative Care/methods , Carcinoma, Non-Small-Cell Lung/surgery , Humans , Lung Neoplasms/surgery , Radiotherapy, AdjuvantABSTRACT
Compared with surgical treatment the combined treatment of patients with non-small cell lung cancer accompanied by post-operative radiotherapy in the mode of hypofractionation from 3 Gy to SOD-36-39 Gy (EQD2 = 43,2-46,8 Gy) allowed statistically significant increasing a 5- and 10-year overall and disease-specific survival in patients with metastases to regional lymph nodes (pN1-2). The increase of overall and disease-specific survival was also observed in patients older than 60 years with the worst initial status (70-80 by the Karnofsky scale), II stage of disease, peripheral cancer and adenocarcinoma however for these groups survival differences did not reach a statistically significant level. The presented method of postoperative irradiation did not have severe toxicity and did not lead to a decrease in survival of elderly and functionally debilitated patients.
