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@ARTICLE{Langer:303014,
author = {S. Langer and D. Medenwald and D. Vordermark and W.
Schuette and K.-M. Deppermann and M. Nothacker and S.
Eggeling and L. Efremov$^*$},
title = {{T}herapeutic modalities for superior sulcus tumor
({P}ancoast) tumor - {A} systematic review.},
journal = {Lung cancer},
volume = {206},
issn = {0169-5002},
address = {Amsterdam [u.a.]},
publisher = {Elsevier},
reportid = {DKFZ-2025-01461},
pages = {108640},
year = {2025},
note = {#LA:C020#},
abstract = {Superior sulcus tumors (SST) are usually treated with
multimodal therapy, mainly trimodal therapy encompassing
radiochemotherapy (CRT) followed by surgery. However,
high-level evidence from randomized trials remains limited.
We conducted a systematic review to assess the evidence of
treatment strategies considering adverse events and
oncologic outcomes.We systematically searched MEDLINE,
CINAHL, EMBASE, Web of Science, CENTRAL, grey literature
databases, and clinical trial registries. We included
prospective and retrospective studies published between 1990
and 2024 with mono-, bi- or trimodal treatment reporting
outcomes such as overall survival (OS), progression-free
survival (PFS), resection rates, postoperative
mortality/morbidity, and adverse events. Studies required
histologically confirmed SST and a minimum of 30
patients.Thirty-five studies were included (28
retrospective, 7 prospective), with follow-up ranging from
10 to 107 months. Most studies originated from Europe (n =
16) and North America (n = 14). Sample sizes ranged from 30
to 2910 patients, predominantly male and aged in the late
50s to early 60s. Induction CRT protocols varied widely. R0
resection rates were reported in 33 studies, and trimodal
therapy outcomes in 12. Hematotoxicity and esophagitis were
the most common adverse events. Five-year OS rates varied
between 11.8 $\%$ and 77 $\%,$ with trimodal therapy
associated with better survival and distant metastasis as
the dominant recurrence pattern. There were no studies
addressing immunotherapy.While trimodal therapy remains the
guideline-endorsed standard for SST, comparative evidence
remains sparse. The role of immunotherapy in induction
regimens warrants further investigation.},
subtyp = {Review Article},
keywords = {Lung cancer (Other) / NSCLC (Other) / Radiochemotherapy
(Other) / Sulcus superior tumor (Other) / Systematic review
(Other)},
cin = {C020},
ddc = {610},
cid = {I:(DE-He78)C020-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:40651130},
doi = {10.1016/j.lungcan.2025.108640},
url = {https://inrepo02.dkfz.de/record/303014},
}