43. Neoadjuvant radiotherapy of epidermiod lung carcinoma patients under short term hypoxia condition

Abstract

Main method of treating the epidermoid lung carcinoma patients is a surgery which gives a 5-year survival of 53–70% of patients with 1 and 2 stage of disease. However, if metastases in lymphatic nodes of mediastinum are present then number of patients surviving this period considerably decreases. To increase surgery effectiveness one seeks the combined therapy methods using, in particular, neoadjuvant radiotherapy. We have studied such a therapy method which is to be applied during the pre-operative period of hypoxiradiotherapy. Date of 237 epidermoid lung carcinoma patients has been analyzed, mainly for the 3-d stage of disease: 1-st group of 123 patients was given a surgery treatment, the second one, of 114 patients, received an additional intensive pre-surgery radiation (5 Gy daily, 20 Gy) under condition of a short term hypoxya of a short term hypoxya caused by a gas mixture of 10% of oxygen and 90% of nitrogen. Surgeries were carried out during the first 3 days after the completing the radiation treatment. Mechanical conditions of the surgery procedure, blood losses and after surgery complications were similar in both cases. The number of cases of general radiation reactions decreased 3 times, all the cases being limited to the 1 and 2 degrees on the RTOG scale. After analysis of deferent factors, which define the result of treatment, significance the most reliable were the size of primary lesion and presence of mediastinum lymphatic nodes metastasis. Was shown rising of 3-year survival rate after combined treatment vs. operative treatment only.