Preventive bilateral pulmonary irradiation in renal neoplasms.

The aim of the study was to evaluate the role of bilateral lung radiotherapy in the prevention of lung metastases from renal cell carcinoma. The preliminary results are presented. Between 1981-1984, 38 patients with renal cell carcinoma with no evident lung metastases and with normal respiratory function (confirmed by gas analysis, spirometry, diffusion test) were submitted to radical nephrectomy with regional lymphadenectomy. The patients were randomly assigned to two groups. 19 patients were treated with lung radiotherapy (1,500 rad in 5 times with overlap on the mediastinum--3,000 rad) two weeks after surgery, 19 patients did not undergo further treatment after surgery. Chest X-rays and functional lung evaluation were performed at 3.6 and 12 months, and then every six months. Results in the first group (lung radiotherapy) showed no cases of lung fibrosis; 15 patients are disease-free (follow-up: 3-36 months); 4 patients died from cancer, only 1 of whom with lung metastases. In the second group (no lung Radiotherapy) 14 patients are disease-free whilst 5 patients died with lung metastases.