Guideline: Pre-operative radical radiotherapy has no routine role.

Level of Evidence: II

Grade of Recommendation: B

There is no clear role for pre-operative radical radiotherapy (without concurrent chemotherapy) at this time. Particular subsets of patients may be considered for pre-operative radiotherapy such as those being considered for resection of superior sulcus tumour, or tumour with invasion into the chest wall. Mutual agreement of the radiation oncologist and surgeon is necessary and such cases are appropriate for presentation at lung conference.

Key References:

1. Curran WJ, Langer CJ, Keller SM, Comis RL. Analysis of clinical trials employing preoperative chemotherapy and/or thoracic radiation therapy for marginally resectable non-small cell lung cancer. J Int Radiat Oncol Biol Phys 1993;27(Suppl 1):189.

2. Temeck BK, Okunieff PG, Pass HI. Chest wall disease including superior sulcus tumors. Lung cancer: Principles and Practice, edited by Pass HI, Mitchell JB, Johnson D, Turrisi A. Lippincott-Raven, Philadelphia, 1996,pp 585.