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Ann Thorac Surg 1994;57:1133-1139
© 1994 The Society of Thoracic Surgeons

Articles

Superior sulcus tumors: Combined modality

Donald B. Fuller, MD*, John S. Chambers, MD

Radiation Medical Group Inc, San Diego, California, USA

Accepted for publication June 17, 1993.

* Address reprint requests to Dr Fuller, 2466 First Ave, San Diego, CA 92101.

Twenty-four patients with superior sulcus tumors were seen between 1955 and 1989. Fifteen of these patients received combined-modality therapy. In 2 patients, this consisted of primary operation followed by postoperative radiotherapy, and, in 13, high-dose conventionally fractionated preoperative radiotherapy (5,500 to 6,475 cGy) followed by en bloc resection. Of the 13 patients who received radiotherapy preopeiatively, 7 survived free of disease beyond 5 years and 2 others remained without evidence of disease after a shorter follow-up (greater than 2 years). The long-term survival in the combined-modality patients in this small series is superior to that reported for other patients receiving combined-modality therapy, and the morbidity appears to be within accepted limits despite the aggressive preoperative radiotherapy program. One postoperative death occurred in our only octogenarian, but there wen no other acute complications. High-dose preoperative radiotherapy using current techniques and fractionation appears to be feasible in conjunction with contemporary surgical techniques. We believe this type of preoperative radiotherapy contributed to the apparent superior survival rate in this series and may also be applicable in the setting of other locally advanced (stage III) bronchogenic carcinomas.




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