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Radiotherapy for cancer of the lung with emphasis on the optimum application in terms of irradiation efficacy and lung tissue damage


, : Radiotherapy for cancer of the lung with emphasis on the optimum application in terms of irradiation efficacy and lung tissue damage. Journal of Tokyo Medical College 42(3): 565-580

Cancer of the lung is an intractable disease with a low cure rate. The reason stems from the high rate of advanced cases among the elderly, and from the degree of malignancy and diverse forms of progression that are associated with such a multi-tissue form of cancer. Radiotherapy, concomitant with surgery, is a potent means of treatment but its success is related to irradiation efficacy and to the extent of damage imparted to normal tissue such as that of the lung and the mediastinal septum. Irradiation efficacy and lung tissue damage are considered from the aspects of irradiation dose, location of irradiation and volume of irradiated region, and have also investigated the optimum form of radiotherapy. From the results it was noted that a correlation exists between extent of pulmonary damage and dose of irradiation and also volume of irradiated region. Thus an important factor in the reduction of damage is to revise the spatial distribution of the radiation dose when planning the radiotherapy. For lesions located in regions where the effects of damage were slight, irradiation of radical cure levels of radiation were clinically possible. In tumors with low susceptibility, in the elderly and in cases of reduced pulmonary function, irradiation must be limited to the main lesion. Concomitant therapy with anticarcinogenic drugs demonstrated a high potential to exacerbate damage, hence the necessity for full consideration of the advantages and disadvantages of concomitant chemotherapy, the concomitant drugs to be used and the method of administration is suggested.

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