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Presurgical irradiation in moderate dosage has converted superior sulcus tumors to operable lesions with prolonged survival in some cases. Previous experience was poor whether the patient received no treatment, irradiation alone, or resection followed by irradiation.7
Bronchogenic carcinomas developing peripherally in the upper lobe of either lung and invading the superior sulcus of the chest (Pancoast's tumor) are usually low-grade epidermoid carcinomas which grow slowly and metastasize late. Situated in the narrow confines of the apex of the chest, they invade early the lymphatics in the endothoracic fascia and involve the lower roots of the brachial plexus, the intercostal nerves, the stellate ganglion, the sympathetic chain, and adjacent ribs and vertebrae, producing severe pain and the Horner's syndrome. Generally such tumors have been considered as not accessible to complete surgical removal and to resist all efforts at irradiation treatment. The average expected time of survival reported in the literature
Paulson DL. The Survival Rate in Superior Sulcus Tumors Treated by Presurgical Irradiation. JAMA. 1966;196(4):342. doi:10.1001/jama.1966.03100170084026