[Influence of preoperative radiotherapy on resection rate and long-term efficacy for patients with stage II and III lung carcinomas].

BACKGROUND &

OBJECTIVE

It is difficult to diagnose lung carcinomas in early stage. Quite a few patients are in advanced stages(partial stage IIIb and IV) and unsuitable for surgical treatment when they come to see doctors with some clinical symptoms. For some patients with stage II and III lung carcinomas, especially associated with ipsilateral hilar and/or mediastinal lymph nodes metastasis, it is very difficult to resect the tumors, or the patients can't tolerate double lobectomy or pneumonectomy because of cardio-pulmonary function deficiency. For these patients, preoperative radiotherapy was chosen firstly in the past, in order to improve resection rate and long-term efficacy. The aim of this study was to explore the effect of resection rate and long-term efficacy of preoperative radiotherapy for stage II and III lung carcinomas.

METHODS

From 1985 to 1995, 62 patients with lung carcinomas (group A) received preoperative radiotherapy and operation. At the same time, 1615 patients with lung carcinomas (group B) received operation alone. The resection rate, 3 and 5-year survival rates and the incidence of postoperative complications for stage II and III lung carcinomas were analyzed.

RESULTS

There were no significant differences of the resection rate(84.2% vs 84.5%, chi 2 = 0.187, P > 0.05), as well as the 3 and 5-year survival rates(chi 2 = 9.86, P > 0.05) between the two groups for stage II and III lung carcinomas. The incidence of complications of group A for stage II and III lung carcinomas was higher than that of group B(12.3% vs 5.8%, chi 2 = 6.84, P < 0.05).

CONCLUSIONS

Preoperative radiotherapy is helpless to improve the resection rate and the long-term survival rate of stage II and III lung carcinomas. In our opinion, it should not be taken into consideration unless it enables surgical resection to be done in the patients with inadequate pulmonary reserve and achieve the same surgical margin as a pneumonectomy.