Pancoast tumor: the value of high dose radiation therapy

Twenty-six patients with superior pulmonary sulcus (Pancoast) tumors were evaluated. Twelve patients were treated with high dose radiotherapy with NSD over 1 900 rets and 10 with NSD less than 1 900 rets. Four patients were treated with combined radiation and surgery. High dose radiotherapy resulted in relief of pain in all patients but apparently did not change survival. Low dose radiotherapy offered relief of pain to only half the patients. Distant metastasis was noted in 30% of patients (15% to brain, 3.8% to liver), rib destruction in 65% and supraclavicular nodes in 19%. Only 4 patients went to surgery and 2 died during operation. We thus conclude that Pancoast tumor is essentially an inoperable disease.