Elective whole lung irradiation.

Whole lung irradiation has been effective in 10 of 17 patients irradiated solely electively (no demonstrable metastatic nodules) who are alive and well 2 to 5 years. Of an additional 17 patients with only one or two demonstrable pulmonary metastases (treated with resection or boost therapy plus whole lung irradiation), 6 are alive and well 5 to 8 years. Only one patient developed clinically significant postirradiation pneumonitis and this case proved to be fatal. Elective whole lung irradiation, especially in conjunction with modern adjuvant chemotherapy, shows promise in improving the survival of patients with tumors having a high propensity for metastasizing to the lungs.