[Results of a controlled clinical trial for evaluation of intensive preoperative irradiation in operable bronchial cancer (author's transl)]

Abstract

To examine the value of an intensive preoperative irradiation on the bronchial carcinoma, 196 operable patients with tumors being histologically confirmed were divided into two groups by drawing the lot: 99 patients for preoperative irradiation, 97 for primary operation. The correspondence of the following criteria was tested and confirmed: age, sex, no symptons, histological tumor type. The preoperative irradiation dose amounted to 5,500 RHD (CO-60). Out of both groups the same number of patients was resected (83 and 85 respectively); within the preoperative irradiated group, however, 11 patients were omitted before the operation (information on reasons), while within the not irradiated group the number of thoracotomized but not resected cases was adequately greater (13). There is no statistically significant difference within the annual survival rate, although the mortality of the primarily operated patients is a bit more favourable. Quite the same is valid for postoperative mortality and complications. The local recurrences (in all cases of necropsy), however, are statistically significant reduced after preoperative irradiation. Since there is no influence on the rate of surviving, the conclusion is drawn that the majority of the operable cases has already developed small distant metastatic formations, being decisive for the prognosis before any therapy was performed. That is why a new prospective series with a low irradiation dose is started, where an increase of complications is not to be expected, but the possibility exists to influence local micrometastatic formations, that means an influence only to those cases with the probability of a low degree of remote metastatic formations.