SHOULD ASYMPTOMATIC PATIENTS WITH INOPERABLE BRONCHOGENIC CARCINOMA RECEIVE IMMEDIATE RADIOTHERAPY - NO

Abstract

This editorial addresses the question of whether asymptomatic patients with bronchogenic carcinoma who are unresectable, who are inoperable because of severe concurrent medical illnesses, or who refuse surgery should be treated with radiation therapy. There is no questioning the palliative effects of radiation therapy on specific symptoms of signs, and a response of 65-97% (usually 75%) should be anticipated. Curative radiotherapy is a distant goal. Radiotherapy of symptomatic patients has not been shown to improve survival beyond that obtainable with palliative radiotherapy of specific problems. The radiotherapist''s profile of a long-term survivor as an asymptomatic, uncomplicated presentation without systemic or metastic manifestation who has a small, well defined peripherally located lesion may reflect their frustration and encourage all clinicians and investigators to pursue additional preventative and therapeutic avenues. Combinations of systemic chemotherapy, immunotherapy and radiotherapy are presently being evaluated. At this time, there remains serious question whether radiotherapy of asymptomatic patients with bronchogenic carcinoma is appropriate.