High-dose radiotherapy in trimodality treatment of Pancoast tumors results in high pathologic complete response rates and excellent long-term survival

Kwong, King F.; Edelman, Martin J.; Suntharalingam, Mohan; Cooper, Lindsay B.; Gamliel, Ziv; Burrows, W.; Hausner, P; Doyle, L. Austin; Krasna, Mark J.

doi:10.1016/j.jtcvs.2004.12.050

Cited by 77 publications

(61 citation statements)

References 15 publications

(16 reference statements)

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“…Even long-term (5-year) survival rates resulted improved reaching 44% (SWOG 9416) and 56% (JCO 9806), respectively. Based on these data, the modern standard treatment for sulcus superior tumors has become the combination of induction CT/RT followed by radical surgical resection (25,29,(35)(36)(37)(38)(39)(40)(41)(42)(43) (Table 1).…”

Section: A B Cmentioning

confidence: 99%

“…Operative mortality rate ranges from 0% to 6.9% and morbidity from 11% to 47% (25,29,(35)(36)(37)(38)(39)(40)(41)(42)(43). In particular, the SWOG 9416 (35) and JCO 9806 (36) phase II trials showed operative mortality rates of 2.3% and 3% and morbidity rates of 52% and 14%, respectively.…”

Section: Complicationsmentioning

confidence: 99%

“…The decrease of local recurrence rate seems to be due to improved surgical technique and appropriate staging. Currently, the pattern of failure has shifted to distant relapses (especially brain relapses) (40)(41)44,50,64). This raises the question of prophylactic brain irradiation (PCI).…”

Section: Prognostic Factors and Relapsesmentioning

confidence: 99%

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Superior sulcus tumors (Pancoast tumors)

et al. 2016

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Section: A B Cmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

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Superior sulcus tumors (Pancoast tumors)

et al. 2016

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“…En-bloc resection of the upper lobe, ribs, nerves (brachial plexus) plus or minus vessels is recommended. Many studies published in the past 10 years have established the gold standard in the field as induction therapy consisting of high dose radiotherapy with concurrent cisplatin-based chemotherapy, followed by surgery 4-6 weeks later [124][125][126][127][128][129]. Using this multimodality scheme, perioperative mortality is low and 5-year survival rates are now consistently .40%.…”

Section: Superior Sulcus Tumours (Pancoast Tumours)mentioning

confidence: 99%

“…Recent studies have shown that complete response to induction therapy was a significant predictive factor for overall survival [124][125][126]. Late central nervous system relapse remains a problem and the role of PCI should be evaluated in this group of patients [129].…”

Section: Superior Sulcus Tumours (Pancoast Tumours)mentioning

confidence: 99%

Surgery for nonsmall cell lung cancer

Lang-Lazdunski

2013

Eur Respir Rev

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Surgery remains the best curative option in patients with early stage lung cancer (stage I and II). Developments in minimally invasive techniques now allow surgeons to perform lung resections on elderly patients, patients with poor pulmonary function or significant cardiopulmonary comorbidities. New techniques, such as stereotactic radiotherapy and ablative procedures, are being evaluated in early-stage lung cancer and may represent an alternative to surgery in patients unfit for lung resection. Perioperative mortality rates have dropped significantly at most institutions in the past two decades and complications are managed more efficiently. Progress in imaging and staging techniques have helped cut futile thoracotomy rates and offer patients the most adequate treatment options. Large randomised trials have helped clarify the role of neoadjuvant, induction and adjuvant chemotherapy, as well as radiotherapy. Surgery remains an essential step in the multimodality therapy of selected patients with advanced-stage lung cancer (stage III and IV). Interventional and endoscopic techniques have reduced the role of surgery in the diagnosis and staging of nonsmall cell lung cancer, but surgery remains an important tool in the palliation of advanced-stage lung cancer. Large national/international surgical databases have been developed and predictive risk-models for surgical mortality/morbidity published by learned surgical societies. Nonetheless, lung cancer overall survival rates remain deceptively low and it is hoped that early detection/screening, better understanding of tumour biology and development of biomarkers, and development of efficient targeted therapies will help improve the prognosis of lung cancer patients in the next decade. @ERSpublications Despite progress in surgical techniques, radiotherapy techniques and targeted therapy, lung cancer prognosis remains poor

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