Portal de Periódicos da CAPES

Superior sulcus tumors: Results of irradiation of 36 patients

1981; Wiley; Volume: 48; Issue: 7 Linguagem: Inglês

10.1002/1097-0142(19811001)48

1097-0142

Ritsuko Komaki, James Roh, James D. Cox, Alberto Lopes da Conceicao,

Lung Cancer Research Studies

CancerVolume 48, Issue 7 p. 1563-1568 ArticleFree Access Superior sulcus tumors: Results of irradiation of 36 patients Ritsuko Komaki MD, Corresponding Author Ritsuko Komaki MD Division of Radiotherapy, The Medical College of Wisconsin, Milwaukee, Wisconsin; and Mt. Sinai Hospital, Milwaukee, WisconsinThe Medical College of Wisconsin, Division of Radiotherapy, 8700 West Wisconsin Avenue, Milwaukee, WI 53226===Search for more papers by this authorJames Roh MD, James Roh MD Division of Radiotherapy, The Medical College of Wisconsin, Milwaukee, Wisconsin; and Mt. Sinai Hospital, Milwaukee, Wisconsin Medical student, The Medical College of Wisconsin.Search for more papers by this authorJames D. Cox MD, James D. Cox MD Division of Radiotherapy, The Medical College of Wisconsin, Milwaukee, Wisconsin; and Mt. Sinai Hospital, Milwaukee, Wisconsin Professor of Radiology, The Medical College of Wisconsin.Search for more papers by this authorAlberto Lopes Da Conceicao MD, Alberto Lopes Da Conceicao MD Division of Radiotherapy, The Medical College of Wisconsin, Milwaukee, Wisconsin; and Mt. Sinai Hospital, Milwaukee, Wisconsin Assistant Professor of Radiology.Search for more papers by this author Ritsuko Komaki MD, Corresponding Author Ritsuko Komaki MD Division of Radiotherapy, The Medical College of Wisconsin, Milwaukee, Wisconsin; and Mt. Sinai Hospital, Milwaukee, WisconsinThe Medical College of Wisconsin, Division of Radiotherapy, 8700 West Wisconsin Avenue, Milwaukee, WI 53226===Search for more papers by this authorJames Roh MD, James Roh MD Division of Radiotherapy, The Medical College of Wisconsin, Milwaukee, Wisconsin; and Mt. Sinai Hospital, Milwaukee, Wisconsin Medical student, The Medical College of Wisconsin.Search for more papers by this authorJames D. Cox MD, James D. Cox MD Division of Radiotherapy, The Medical College of Wisconsin, Milwaukee, Wisconsin; and Mt. Sinai Hospital, Milwaukee, Wisconsin Professor of Radiology, The Medical College of Wisconsin.Search for more papers by this authorAlberto Lopes Da Conceicao MD, Alberto Lopes Da Conceicao MD Division of Radiotherapy, The Medical College of Wisconsin, Milwaukee, Wisconsin; and Mt. Sinai Hospital, Milwaukee, Wisconsin Assistant Professor of Radiology.Search for more papers by this author First published: 1 October 1981 https://doi.org/10.1002/1097-0142(19811001)48:7 3.0.CO;2-HCitations: 70 Assistant Professor of Radiology, The Medical College of Wisconsin. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract Thirty-six patients with superior sulcus tumors were treated primarily with irradiation at the Medical College of Wisconsin Affiliated Hospitals between 1963–1977. Two patients were Stage II (T2NO) and 34 patients were Stage III (22: T3NO and 12: T1-3N2). Local control correlated positively with the field size for the thoracic irradiation, but not with total dose (between 40 Gy in four weeks and 64 Gy in 6 1/2 weeks). Thirty-one patients (86%) had relief of symptoms for a median of 12 months after irradiation. Seventeen patients (47%) achieved local control and showed a significantly longer median survival (26.5 months vs. 6.5 months) and a higher probability of five-year survival (45% vs. 0) compared with those who did not. Of 19 patients with local failure, distant metastases developed in nine. The most common first and single metastatic site was the brain. Brain metastases developed in seven patients, six of whom had control of the primary tumor. Three of them were alive at 65, 35, and 25 months after whole-brain irradiation. The five-year actuarial survival rate was 23%. There were no major complications. The prognosis was related to local control, but was unrelated to age, histology, symptoms, and signs at presentation, or mediastinal involvement, perhaps the result of the small number of patients studied. The prognosis for patients with superior sulcus tumors is more favorable than other presentations of carcinoma of the lung, but patients are especially at risk for single-organ brain metastases. Primary external radiotherapy is as effective as combined approaches and has a low complication rate; therefore, it is to be preferred for most patients with apical tumors. References 1 Pancoast HK. Importance of careful roentgenray investigations of apical chest tumors. JAMA 1924; 83: 1407– 1411. 2 Pancoast HK. Superior pulmonary sulcus tumor. JAMA 1932; 99: 1391– 1396. 3 Byrd RB, Carr DT, Miller WE, Payne WS, Woolner LB. Radiographic abnormalities in carcinoma of the lung as related to histiological cell type. Thorax 1969; 24: 573– 575. 4 Haas LL, Harvey RA, Melchor CF. Radiation management of apical lung tumors. J Thorac Cardiovas Surg 1957; 33: 496– 525. 5 Bretz G, Lott S, El-Mahdi A, Hazra T. The response of superior sulcus tumors to radiation therapy. Radiology 1970; 96: 145– 150. 6 Kirsh MM, Dickerman R, Fayos J, et al. The value of chest wall resection in the treatment of superior sulcus tumors of the lung. Ann Thorac Surg 1973; 15: 339– 346. 7 Mantell BS. Superior sulcus (Pancoast) tumours: Results of radiotherapy. Br J Dis Chest 1973; 67: 315– 318. 8 Morris RW, Abadir R. Pancoast tumor: The value of high dose radiotherapy. Radiology 1979; 132: 717– 719. 9 Hilaris BS, Martini N, Liskow A, Batata MA, Beattie EJ Jr. Superior sulcus lung cancer: A 35 year experience. Int J Radiat Oncol Biol Phsy 1979; 5: 54. 10 Hilaris BS, Martini N, Luomanen RKJ, Batata M, Beattie EJ Jr. The value of preoperative radiation therapy in apical cancer of the lung. Surg Clin North Am 1974; 54: 831– 840. 11 Paulson DL. Treatment of superior sulcus tumors. In: BF Rush, RH Greenlaw, eds. Cancer Therapy by Integrated Radiation and Operation. Springfield, Illinois: Charles C Thomas, 1968; 74– 82. 12 Paulson DL. The survival rate in superior sulcus tumors treated by presurgical irradiation. JAMA 1966; 196: 342, April. 13 Paulson DL. Superior sulcus tumors: Results of combined therapy. NY State J Med 1971; 71: 2050– 2052. 14 Paulson DL. Carcinoma in the superior pulmonary sulcus. Ann Thorac Surg 1979; 28: 3– 4. 15 Mallams JT, Paulson DL, Collier RE, Shaw RR. Presurgical irradiation in bronchogenic carcinoma, superior sulcus type. Radiology 1964; 82: 1050– 1054. 16 Miller JI, Mansour KA, Hatcher CR. Carcinoma of the superior pulmonary sulcus. Ann Thorac Surg 1979; 28: 44– 47. 17 American Joint Committee for Cancer Staging and End-Results Reporting: Manual for Staging of Cancer 1978. Chicago, 1978; 15– 26, 59–64. 18 Karnofsky DA, Abelmann WH, Craver LF, Burchenal JH. The use of nitrogen mustards in the palliative treatment of cancer. Cancer 1948; 1: 634– 656. 19 Hyde L, Wolf J, McCracken S. Natural course of inoperable lung cancer. Chest 1973; 64: 309– 312. 20 Komaki R, Cox JD, Eisert DR. Irradiation of bronchial carcinoma—II. Pattern of spread and potential for prophylactic irradiation. Int J Radiat Oncol Biol Phys 1977; 2: 441– 446. 21 Cox JD, Yesner RA. Adenocarcinoma of the lung: Recent results from the Veterans Administrahg Lung Group. Am Rev Resp Dis 1979; 120: 1025– 1029. 22 Nugent JL, Bunn PA Jr, Matthews MJ et al. CNS metastases in small cell bronchogenic carcinoma: increasing frequency and changing pattern with lengthening survival. Cancer 1979; 44: 1885– 1893. 23 Hepper NGG, Herskovic T, Witten DM, Mulder DW, Woolner LB. Thoracic inlet tumors. Ann Int Med 1966; 64: 979– 989. Citing Literature Volume48, Issue71 October 1981Pages 1563-1568 ReferencesRelatedInformation