Radiation therapy in bronchial carcinoma

In bronchial carcinoma, the course of the disease is mainly determined by the rate of tumoral growth and by distant metastasition frequently occurring. Histology of the tumor and the stage of the disease are most important for prognostication. Until distant metastases are demonstrabe, a patient may be regarded as potentially curable by means of sole radiation therapy. The choice of the therapy decisively depends on histological analysis. Surgical treatment will give the best curative chance to non small cell carcinomas, while small cell carcinoma will be treated by primary irradiation, being apparently superior in this case. Concomitant therapy with cytostatics may improve the results. Exactness in treatment planning and the use of split-course therapy will improve the tolerability of the irradiation. Immunotherapy seems to prolong the survival. It will be important, in future, to search for parameters, primary ones and parameters observed in the course of treatment, permitting to find out the group of patients which may still be cured by an aggressive therapy. Unnecessary load on a large group of patients who only need palliative therapy thus would be avoided. (orig./MG)