SUPERIOR SULCUS TUMORS - COMBINED-MODALITY

Twenty-four patients with superior sulcus tumors were seen between 195 5 and 1989. Fifteen of these patients received combined-modality thera py. In 2 patients, this consisted of primary operation followed by pos toperative radiotherapy, and, in 13, high-dose conventionally fraction ated preoperative radiotherapy (5,500 to 6,475 cGy) followed by en blo c resection. Of the 13 patients who received radiotherapy preoperative ly, 7 survived free of disease beyond 5 years and 2 others remained wi thout evidence of disease after a shorter follow-up (greater than 2 ye ars). The long-term survival in the combined-modality patients in this small series is superior to that reported for other patients receivin g combined-modality therapy, and the morbidity appears to be within ac cepted limits despite the aggressive preoperative radiotherapy program . One postoperative death occurred in our only octogenarian, but there were no other acute complications. High-dose preoperative radiotherap y using current techniques and fractionation appears to be feasible in conjunction with contemporary surgical techniques. We believe this ty pe of preoperative radiotherapy contributed to the apparent superior s urvival rate in this series and may also be applicable in the setting of other locally advanced (stage III) bronchogenic carcinomas.