Zbigniew Jodkiewicz

Rola chemioterapii i radioterapii uzupełniającej u chorych na niedrobnolomórkowego raka płuca po zabiegu operacyjnym

Value of radio- and chemotherapy for patients with non-small lung carcinoma after surgery. Radiotherapy is an important method of adjuvant treatment of non-small lung carcinoma (NSLC), but hitherto existing outcomes do not indicate its potential benefits. Results of meta-analysis published in 1998 on post-operative radiotherapy (PORT) showed, that the post-operative radiation unfavorably influences survival rate resulting in relative increase of death cases on the level of 21 per cent and an absolute decrease in 2 years survival (7 %). May be the reason of these outcomes was application of old radiation techniques. Modern 3D radiotherapy and improved dosymetry just recently introduced into everyday clinical practice may prove in the future its efficiency and improve outcomes of therapy. In 1995 post-operative chemotherapy brought small benefits in the treatment of NSLC. However latest clinical trials (NCIC, IBR10, ANITA) in which to the cisplatin regime has been supplemented by vinorelbine suggest an improvement in survival rate after systemic adjuvant chemotherapy and contributed to the change in the treatment of patients with NSLC after radical surgery. Actually there are carried several clinical trials with the aim to determine the future place of the post-operative chemotherapy and further information concerning patients enrolment and optimal schemes of treatment are expected.