Combined Treatment in Superior Sulcus Tumors

Martı́nez-Monge, Rafael; Herreros, Jesús; Aristu, Javier; Aramendía, José Manuel; Azinovic, I.

doi:10.1097/00000421-199408000-00007

Cited by 67 publications

(35 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This was also supported by the findings of recent studies showing that induction chemoradiotherapy and surgery afford high local resectability rates and long-term disease control for patients with SST [10][11][12].…”

supporting

confidence: 69%

“…This was also supported by the findings of recent studies showing induction chemoradiotherapy and surgery to afford high local resectability rates and long-term disease control for patients with SST. MARTíNEZ-MONGE et al [10] reported the results of the first phase II trial with a multidisciplinary approach, which included 1-3 cycles of neoadjuvant chemotherapy (mitomycin/vinblastine/cisplatin (MVP) or mitoxantrone/ chlorambucil and prednisone regimen) followed by simultaneous pre-operative chemotherapy and external beam irradiation (46-50 Gy). Treatment-related mortality was high (3/18 patients, 16.6%).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Induction chemotherapy, concurrent chemoradiation and surgery for Pancoast tumour

Marra¹,

Eberhardt²,

Pöttgen³

et al. 2006

European Respiratory Journal

View full text Add to dashboard Cite

The traditional treatment of Pancoast tumour with local approaches (surgery, radiotherapy or a combination of both) leads to a poor outcome due to the high rate of incomplete resection and the lack of systemic control. The aim of the present prospective feasibility study was to determine whether a trimodality approach improves local control and survival.Patients with stage IIB-IIIB Pancoast tumour received induction chemotherapy (three courses of split-dose cisplatin and etoposide or paclitaxel) followed by concurrent chemoradiotherapy (a course of cisplatin/etoposide combined with 45 Gy hyperfractionated accelerated radiotherapy). After restaging, eligible patients underwent surgery 4-6 weeks post-radiation.A total of 31 consecutive patients with T3 (81%) or T4 (19%) Pancoast tumour were enrolled in the study. Induction chemoradiotherapy was completed in all patients without treatment-related deaths. Grade 3-4 toxicity was observed in 32% of cases. In total, 29 (94%) patients were eligible for surgery. Complete resection was achieved in 94% of patients. The post-operative mortality rate was 6.4% and major complications arose in 20.6% of the patients. The median survival was 54 months with 2-and 5-yr survival rates of 74 and 46%, respectively.In conclusion, this intensive multimodality treatment of Pancoast tumour is feasible and improves local resectability rates and long-term survival as compared with historical series.

show abstract

supporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Induction chemotherapy, concurrent chemoradiation and surgery for Pancoast tumour

Marra¹,

Eberhardt²,

Pöttgen³

et al. 2006

European Respiratory Journal

View full text Add to dashboard Cite

show abstract

“…A corollary of this is the possibility of accomplishing a less radical resection with less perioperative and long-term morbidity. Martinez-Monge et al (39) showed the 4-year survival with induction therapy for T 3 and T 4 superior sulcus disease to be 56%. In two other studies examining induction therapy for superior sulcus tumors, Rusch et al (10,11) and Wright et al (40), showed 5-year survival rates of (n = 111) 55% and (n = 49) 84%, respectively.…”

Section: Inductiontherapy Fort 3 Ort 4 Tumorsmentioning

confidence: 99%

Surgical Management of T3 and T4 Lung Cancer

DiPerna

Wood

2005

Clinical Cancer Research

View full text Add to dashboard Cite

Locally advanced lung cancer (T 3 or T 4 ) has a significantly worse prognosis than lower stage disease. However, this diagnosis is usually made radiologically, and experienced thoracic surgeons are familiar with the low radiologic to pathologic correlation in tumors that abut the great vessels, mediastinum, or chest wall. Commonly these tumors do not directly invade adjacent structures and are, in fact,T 1 orT 2 tumors that are resectable through standard techniques. Where there is no clearly evident invasion of unresectable structures, the patient should be given the benefit of the doubt and considered at a lower (resectable) stage until proven otherwise. The curability of T 3 tumors varies according to the involved site. A T 3 N 0 tumor involving the chest wall provides the most favorable prognosis among the resected T 3 lesions, with a 5-year survival of >50% in lymph node^negative patients if resection is complete. Palliative incomplete resections of T 4 disease, in which tumor has invaded mediastinal structures, have not shown any survival benefit and are associated with very high morbidity and mortality. However, patients with limited invasion of the carina, left atrium, superior vena cava, or pulmonary artery may be able to be completely resected despite their T 4 classification. Surgical resection remains an important part of the therapy for patients with locally advanced lung cancer. Modern techniques of chest wall resection and reconstruction and bronchoplastic procedures allow complete resection of locally advanced tumors with favorable 5-year survival rates and low morbidity and mortality.

show abstract

“…Techniques using brachytherapy [31] and intraoperative radiotherapy [32] have shown promising results in highly selected patients. These techniques are not widely available, nor is there information regarding long-term morbidity.…”

Section: Treatmentmentioning

confidence: 99%

Superior Sulcus Tumors: A Mini-Review

Archie¹,

Thomas

2004

The Oncologist

View full text Add to dashboard Cite

The management and outcome for superior sulcus tumors have remained unchanged for 40 years. The rarity of these tumors has led to varying treatment techniques spanning decades, from which no solid conclusions can be drawn. Recent advances in combined-modality therapy have offered the first inkling that a paradigm shift is on the horizon. Here, we review the history and new advances in treating this challenging pulmonary neoplasm. The Oncologist 2004;9:550-555 The Oncologist 2004;9:550-555 www.TheOncologist.com Antonio, 7703 Floyd Curl Dr., San Antonio, Texas 78229, USA. Telephone: 210-616-5684; Fax: 210-949-5085; e-mail: cthomas@ctrc.net; Website: http://www.uthscsa.edu/radiationoncology Received January 27, 2004; accepted for publication May 10, 2004. ©AlphaMed Press 1083-7159/2004 In 1924, Pancoast [1] reported the clinical and radiographic findings associated with superior sulcus tumors. He initially thought that these tumors arose from epithelial rest cells from the fifth brachial cleft. Eight years later, Tobias [2] and Pancoast [3] simultaneously, correctly recognized that bronchogenic carcinoma was the primary cause of this syndrome. Correspondence: Charles R. Thomas Jr., M.D., Department of Radiation Oncology, University of Texas Health Science Center at San HISTORYSuperior sulcus tumors usually arise in the apex of the lung and may invade the second and third ribs, the brachial plexus, the subclavian vessels, the stellate ganglion, and adjacent vertebral bodies [4]. Pancoast syndrome is characterized by pain, which may arise in the shoulder or chest wall or radiate to the neck. Pain characteristically radiates to the ulnar surface of the hand. Horner's syndrome, which is composed of ptosis, meiosis, and anhydrosis, results from invasion of the paravertebral sympathetic chain. Weakness and atrophy of the hand and parasthesias are a common clinical finding resulting from invasion into the C8 and T1 roots of the brachial plexus. More infrequent manifestations include supraclavicular adenopathy, superior vena cava syndrome, and involvement of the phrenic or laryngeal nerves [5].Prior to the 1950s, superior sulcus tumors were uniformly fatal. Chardack and MacCallum [6] reported the The Oncologist ® Lung Cancer LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Describe the diagnostic work-up for superior sulcus (Pancoast) tumors of the lung.2. List the major prognostic factors pertaining to outcome in patients with superior sulcus (Pancoast) tumors.3. Discuss the recent (SWOG 94-16) and current (SWOG-0220) intergroup trials for superior sulcus (Pancoast) tumors.Access and take the CME test online and receive 1 hour of AMA PRA category 1 credit at CME.TheOncologist.com CME CME by guest on May 9, 2018 http://theoncologist.alphamedpress.org/ Downloaded fromThis material is protected by U.S. Copyright law.Unauthorized reproduction is prohibited. For reprints contact: Reprints@AlphaMedPress.com first successful treatment with resection followed by postoperative radiation...

show abstract

Combined Treatment in Superior Sulcus Tumors

Cited by 67 publications

References 0 publications

Induction chemotherapy, concurrent chemoradiation and surgery for Pancoast tumour

Induction chemotherapy, concurrent chemoradiation and surgery for Pancoast tumour

Surgical Management of T3 and T4 Lung Cancer

Superior Sulcus Tumors: A Mini-Review

Contact Info

Product

Resources

About