Chest
Clinical InvestigationsInitial Combined Cryotherapy and Irradiation for Unresectable Non-small Cell Lung Cancer: Preliminary Results
Section snippets
Patients
From March 1986 to October 1990, we have included in a prospective monocentric protocol 38 successive patients (35 men; 3 women) who presented with a symptomatic obstructive tumor of the trachea or of a major bronchus secondary to unresectable non-small cell lung cancer (NSCLC) without metastases. Carcinoids or adenoid cystic carcinomas were excluded.
According to the TNM13 staging (including a computed tomographic scan), the tumors in these patients were judged unresectable either (1) for
Side Effects
The protocol was achieved in 36 out of the 38 patients; the two remaining patients received only 35 Gy (cases 27 and 33) due to poor tolerance. No significant side effect occurred after cryotherapy. Four side effects could be associated with irradiation: 2 instances of irradiation pneumonitis (1 death; case 1); 1 postirradiation tracheal stenotic scar (case 22); and 1 necrosis of the tumor with bronchoesophagal fistula leading to the death of the patient (case 24).
Results of Cryotherapy
Cryotherapy was considered
DISCUSSION
This preliminary and nonrandomized study cannot assess whether the benefit of cryotherapy is due to the debulking action of cold or to a patent radiosensitization effect. It is also not possible to precisely determine whether cryotherapy with radiotherapy is a better combined therapy than laser with radiotherapy for these indications.
Nevertheless, this study confirms some important points: (1) cryotherapy is a very safe method, which did not induce severe side effects in this protocol; the
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Manuscript received December 30, 1991; revision accepted March 25, 1992.