Postoperative radiotherapy after pneumonectomy: Impact of modern treatment facilities

Phlips, P.; Rocmans, Pierre Arthur; Vanderhoeft, P; Houtte, Paul Van

doi:10.1016/0360-3016(93)90375-6

Cited by 68 publications

(30 citation statements)

References 12 publications

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“…15 The early 1990s were associated with the combining of the LINAC with CT imaging, resulting in 3-dimensional (3-D) conformal radiotherapy. Improvements in these various components of radiation therapy have resulted in an improved ability to deliver safe radiation doses to primary tumors and, at the same time, greater sparing of normal tissues.…”

Section: Discussionmentioning

confidence: 99%

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The risk of death from heart disease in patients with nonsmall cell lung cancer who receive postoperative radiotherapy

Lally

Detterbeck

Geiger

et al. 2007

Cancer

106

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A range of flat hot‐compacted single‐polymer composite panels made from oriented polypropylene and polyethylene with differing dynamic modulus and damping capacity were freely suspended and subjected to mechanical excitation, allowing their acoustic frequency response over the audio bandwidth to be measured. The audio response over selected bands was correlated with the dynamic modulus and damping capacity measured in bending in these materials and compared with the response of a traditional composite material, namely, carbon‐fiber‐reinforced epoxy resin. Low damping and high dynamic modulus were found to result in relatively high output levels from the hot‐compacted flat panels, which contrasted with the results previously measured on a traditional cone‐shaped speaker made from a hot‐compacted polypropylene material, which found high damping to be advantageous. The results of the current study on flat panels are explained in terms of mechanical impedance of the panels and their corresponding efficiency. It was concluded that the best flat‐panel audio response came from compacted polyethylene sheets, which combined high stiffness, low density, and a low level of damping. © 2005 Wiley Periodicals, Inc. J Appl Polym Sci, 2006

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Section: Discussionmentioning

confidence: 99%

“…15,16 Taken together, these critical components of radiation delivery may have deleterious consequences in a population of patients with already compromised cardiac and pulmonary reserve.…”

mentioning

confidence: 99%

The risk of death from heart disease in patients with nonsmall cell lung cancer who receive postoperative radiotherapy

Lally

Detterbeck

Geiger

et al. 2007

Cancer

106

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“…They concluded that thoracic radiation therapy (TRT) should not be recommended in N0 patients. Those same authors pointed out, in a subsequent study, that more modern PORT techniques using linear accelerators instead of 60 Co could improve the outcome of patients [21]. The 5-year survival rate was only 8% among patients treated with 60 Co, whereas it was 30% in patients treated in modern facilities.…”

Section: Randomized Trials Of Adjuvant Rt In Stage I Resected Nsclc Pmentioning

confidence: 99%

Role of Postoperative Radiotherapy in Resected Non-Small Cell Lung Cancer: A Reassessment Based on New Data

Péchoux

2011

The Oncologist

116

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After completing this course, the reader will be able to: 1. Identify patients with non-small cell lung cancer who may benefit from postoperative radiotherapy based upon current evidence. 2. Summarize the results of analyses of both older and more recent data regarding postoperative radiotherapy in NSCLC patients. ABSTRACT In completely resected non-small cell lung cancer (NSCLC) patients with pathologically involved mediasti-nal lymph nodes (N2), administration of adjuvant platinum based chemotherapy is now considered the standard of care, based on level 1 evidence. The role of postoperative radiation therapy (PORT) in this group of patients remains controversial. The PORT meta-analysis published in 1998 concluded that adjuvant radiotherapy was detrimental to patients with early-stage completely resected NSCLC, but that the role of PORT in the treatment of tumors with N2 involvement was unclear, and that further research was warranted. Recent retrospective and non-randomized studies, as well as subgroup analyses of recent randomized trials evaluating adjuvant chemotherapy, provide evidence of the possible benefit of PORT in patients with mediastinal nodal involvement. The role of PORT is also a valid question in patients with proven N2 disease who have undergone only induction chemotherapy followed by surgery, because the local recurrence rate for such patients varies in the range of 20%-60%. Based on the currently available data, PORT should be discussed for fit patients with completely resected NSCLC with N2 nodal involvement, preferably after completion of adju-vant chemotherapy. There is a need for new randomized evidence to evaluate PORT using the modern three-dimensional conformal radiation technique, with attention paid to reducing the risk for, particularly, pulmonary and cardiac toxicity. A new large multi-institutional randomized trial evaluating PORT in this patient population is needed and now under way. The Oncologist 2011;16:672-681

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“…As reported in Table 2 the PORT studies included patients treated on 60 Co units: such units are no longer acceptable for the treatment of lung cancer patients. In fact, in one non-randomised study of AR, 5-year survival for patients treated on a 60 Co unit was 8% compared with 30% for patients treated on a linear accelerator [19]. In this setting, according to Munro [33], we do believe that data obtained from obsolete equipment cannot be directly relevant to contemporary practice.…”

Section: Discussionmentioning

confidence: 90%

Radiotherapy versus follow-up in the treatment of pathological stage Ia and Ib non-small cell lung cancer. Early stopped analysis of a randomized controlled study✩

Granone

Trodella

Margaritora

et al. 2000

European Journal of Cardio-Thoracic Surgery

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Objective: This is an analysis of a randomized controlled clinical trial planned to evaluate the effects of adjuvant radiotherapy (AR) on the local recurrence rate in patients with non-small cell lung cancer (NSCLC) with pathological stage (pStage) Ia (pT1N0) and Ib (pT2N0). The effects of AR on the long-term survival have also been marginally evaluated. Materials and methods: This clinical trial was planned with the hypothesis that AR on pStage Ia and Ib, R0 NSCLCs was effective on local recurrence rate. From July 1989 through March 1997, 104 patients with NSCLC who presented with pStage Ia and Ib have been observed and treated and entered the study. Male/female ratio was 91:13; the mean age was 62 years (range 41±75 years). All patients underwent major pulmonary resection and homolateral standard hilar and mediastinal lymph node dissection. pStage was T1N0 in 29 and T2N0 in 75 cases. Patients have been randomized`by chance' into two groups (G1 and G2). G1 received radiotherapy, G2 did not receive any adjuvant treatment. Fifty-two patients entered G1 and 52 entered G2. Results: Post-operative mortality was nil. Seven patients have been excluded from the study (four in G1 and three in G2), due to incomplete follow-up data. We do not report any radiotherapy-related complication or deterioration of lung function. The treatment effect on the local recurrence rate demonstrated a clearly signi®cant protective effect of the AR. No statistically signi®cant difference was found from the comparison of the 5-year survival rate of the treated (83%) versus untreated (70%) patients. No detrimental effect of the radiotherapy has been assessed. Conclusions: AR in the treatment of pStage Ia and Ib NSCLC has been well tolerated and had a signi®cant relative effect on the local recurrence rate but did not signi®cantly modify overall survival even if a positive trend in the group of treated patients is reported. q

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Postoperative radiotherapy after pneumonectomy: Impact of modern treatment facilities

Cited by 68 publications

References 12 publications

The risk of death from heart disease in patients with nonsmall cell lung cancer who receive postoperative radiotherapy

The risk of death from heart disease in patients with nonsmall cell lung cancer who receive postoperative radiotherapy

Role of Postoperative Radiotherapy in Resected Non-Small Cell Lung Cancer: A Reassessment Based on New Data

Radiotherapy versus follow-up in the treatment of pathological stage Ia and Ib non-small cell lung cancer. Early stopped analysis of a randomized controlled study✩

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