[The role of radiotherapy in bronchopulmonary cancer]

Pulmonary cancer is a major problem as much in terms of public health as for treatment. Radiotherapy plays an important therapeutic role. For a long time it has been used to treat inoperable tumours and for palliation, none the less in certain clinical situations it can be used as an alternative cure: in that case it's most often integrated with surgery and-or chemotherapy. Modern techniques of localization and of planning treatment have been briefly reviewed. In small cell cancer the survival is improved, as well as local control by thoracic irradiation. Current research has produced new knowledge in radiobiology which is opening up new therapeutic possibilities in the treatment of this disease. Various schemas for fractionating the radiotherapy and its sophisticated integration with chemotherapy have enable notable progress. Non-small cell bronchial cancer presents a particular challenge on account of its relative insensitivity to chemotherapy. Treatment is based on surgery and radiotherapy. Radiotherapy is a useful alternative to surgery for those patients who are inoperable on account of poor respiratory function. For cancer which has advanced locally new strategies of induction by associating radiotherapy and chemotherapy prior to surgery are under evaluation. Numerous cases of advanced disease are typically treated with radiotherapy alone. New schemas for hyperfractioning are giving rise to promising results and are clearly beneficial in combination with other therapeutic approaches. The side effects of thoracic irradiation can be controlled; the most serious can be prevented by careful attention to the volume treated and to the technique of irradiation. Radiotherapy offers an effective alternative and has a good cost effective relationship for the palliative treatment of metastatic lesions. The optimal use of these local and systemic therapies would enable an improvement in the evolution of the disease in these patients with pulmonary cancer.