Accelerated hemithoracic radiation followed by extrapleural pneumonectomy for XXXX .

@entity1 @entity3620 @entity137
OBJECTIVE: To evaluate a new protocol of accelerated hemithoracic intensity-modulated radiation therapy (IMRT) followed by extrapleural pneumonectomy (EPP) for @entity1 with resectable @entity3620 ( @entity3620 ). METHODS: A total of 25  Gy of radiation was delivered in 5 daily fractions over 1  week to the entire ipsilateral hemithorax with concomitant boost of 5  Gy to volumes at high risk based on computed tomography and positron emission tomography scan findings. EPP was performed at 6      2  days after the end of radiation therapy. Adjuvant chemotherapy was offered to @entity1 with ypN2 disease. RESULTS: A total of 62 @entity1 were included between November 2008 and October 2014. One @entity1 died in the hospital 2  months after EPP, for an operative mortality of 1.6%, and 2 died after discharged from the hospital for an overall treatment-related mortality (grade 5 @entity137 ) of 4.8%. Twenty-four @entity1 (39%) developed grade 3 to 5 (grade 3+) complications. On final pathology, 94% of the @entity1 were stage III or IV, and 52% had ypN2 disease. The median survival for all @entity1 as an intention-to-treat analysis was 36  months. The median overall survival and disease-free survival was 51 and 47  months, respectively, in epithelial subtypes, compared with 10 and 8  months in biphasic subtypes (P  =  .001). Ipsilateral chest recurrence occurred in 8 @entity1 . CONCLUSIONS: Accelerated hemithoracic IMRT followed by EPP has become our preferred approach for resectable @entity3620 . The results have been encouraging in @entity1 with epithelial subtype.
