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The Role of Radiotherapy in Carcinoma of the Bronchus

  • Adrian R. Timothy
Chapter

Abstract

Lung cancer is not a single disease but a heterogeneous group of diseases with differing histological subtypes and patterns of evolution (Seydel et al. 1976; Cox et al. 1979; Gazdar et al. 1983). While it is likely that the majority of patients will ultimately develop distant metastases, the behaviour of individual lung tumours at presentation may be quite different (Spjut and Mateo 1965; Matthews et al. 1973; Rissanen et al. 1968). At one end of the spectrum, small cell carcinomas tend to pursue a rapid course with a high propensity for early dissemination, and traditionally carry the worst prognosis (Kirsh et al. 1972). At the other extreme, a small number of the well differentiated epidermoid tumours will not metastasise until late in the disease — some of these patients may be cured by local therapy, either surgery or radiation, while others will succumb to uncontrolled primary disease but without evidence of distant spread (Spjut and Mateo 1965; Kirch et al. 1972; Matthews et al. 1973; Abadir and Muggia 1975; (Cox et al. 1979; Schaake-Koning et al. 1983). More recently certain histological subsets, in particular small cell carcinoma, have been shown to be responsive to combination cytotoxic chemotherapy, and a number of long-term survivors are now recorded among individuals presenting with clinically localised tumours (Arnold and Williams 1979; Hansen et al. 1980; Greco and Oldham 1979; Smith et al. 1981). With these few exceptions, the long-term outlook for lung cancer patients is poor. In the face of apparent advances in diagnostic and treatment techniques, the overall prognosis has not altered significantly over the past 30 years — less than 10% of all patients may be expected to survive for 5 years after initial diagnosis (Green 1981; Chilvers 1982).

Keywords

Lung Cancer Brain Metastasis Small Cell Lung Cancer Superior Vena Caval Small Cell Carcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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  • Adrian R. Timothy

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