Five-year results by intensive high voltage therapy of inoperable bronchial carcinoma

Abstract

The influence of intensive radiotherapy on cure and survival rates in the case of inoperable bronchial carcinoma is investigated in 1046cases with histologically confirmed tumours limited to one thorax side. Thirty-seven per cent 1-yr, and 2.5% 5-yr cures were achieved by telecobalt therapy with > 50 Gy (5000 rad) tumour-dose. For highly differentiated carcinomas we obtained 6.5% and for small-cell carcinomas 2.5% 5-yr survival rates. The increase in survival rates as compared with our control group of untreated but prognostically more favourable cases ( 105 thoractomized patients) as well as with our patients treated with 200kV therapy can be regarded as convincing (double the rate of 1-yr and more than three times of 2-yr survival). Nevertheless, the total result for more than half of the cases is so unfavourable that trials with systemic therapy, though of an invasive kind, must be regarded as justified. Up to this time chemotherapy does not influence the survival times (with the exception of small-cell tumour types). Therefore randomized trials with highly dosed, prophylactic irradiation of the whole body [2 × 8 Gy ( 800 rad) midline-dose] are recommended. My own experiences with this method confirm the unexpectedly high subjective tolerance.