The successful treatment of lung cancer by any modality alone remains highly disappointing. It is for this reason that combined approaches using surgery, irradiation, and chemotherapy are being widely explored. The natural history of lung cancer and host resistance determines which lesions remain localized, which ones spread regionally, and which will disseminate widely. Since the most elaborate preoperative diagnostic methods cannot predict the development of metastatic spread microscopically, adjuvant therapy has been instituted with the hope of increasing salvage in favorable cases.
The main advocates of preoperative irradiation were interested in determining if irradiation could arrest the local growth and sterilize reginal hilar, mediastinal, and scalene nodes, extending the number of patients who could be managed surgically. The possibility of rendering inoperable cases operable has been studied in the process. The gains in survival, the lowering of regional recurrences, and the prevention of metastases have also been analyzed in reference