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The long-term outcomes of induction chemoradiotherapy followed by surgery for locally advanced non-small cell lung cancer.

Uramoto H, Akiyama H, Nakajima Y, Kinoshita H, Inoue T, Kurimoto F, Nishimura Y, Saito Y, Sakai H, Kobayashi K - Case Rep Oncol (2014)

Bottom Line: Induction chemoradiotherapy followed by surgery for LA-NSCLC provided a favorable prognosis for selected patients.A complete pathological response was found in about half of cases.This strategy is feasible and was associated with low morbidity and high resectability rates, suggesting that it contributed to improving the treatment results.

View Article: PubMed Central - PubMed

Affiliation: Division of Thoracic Surgery, Saitama Cancer Center, Saitama, Hidaka, Japan.

ABSTRACT

Background: Although the concept of induction therapy followed by surgical resection for locally advanced non-small cell lung cancer (LA-NSCLC) has found general acceptance, the appropriate indications and the strategy for this treatment are still controversial.

Methods: From 2000 through 2008, 36 patients received concurrent chemoradiotherapy followed by surgery. We retrospectively reviewed these cases, analyzed the outcomes and examined the prognosis.

Results: The median radiation dose given was 60 Gy. Chemotherapy included a platinum agent in all cases; cisplatin-based chemotherapy was administered to 9 cases, and a carboplatin-based chemotherapy regimen was administered to 27. A complete resection was performed in 94% of the patients. Seventeen (47.2%) patients exhibited a complete pathological response, and downstaging was induced in 26 (72%) cases. The morbidity and 30-day mortality rates were 11.1 and 0%, respectively. The 5-year overall survival rate in the patients with complete resection (n = 33) was 83.3%.

Conclusions: Induction chemoradiotherapy followed by surgery for LA-NSCLC provided a favorable prognosis for selected patients. A complete pathological response was found in about half of cases. This strategy is feasible and was associated with low morbidity and high resectability rates, suggesting that it contributed to improving the treatment results.

No MeSH data available.


Related in: MedlinePlus

The results of Kaplan-Meier analyses of the OS of patients stratified by histology, pathological response and downstaging. a The 5-year OS rate in both the non-SQ (thin line) and SQ (thick line) patients was 77.8%. b The 5-year OS rates in the Ef1–2 (thick line) and Ef3 (thin line) patients were 72.7 and 81.9%, respectively (p = 0.55). c The 5-year OS rates in the patients with downstaging (thick line) and without downstaging (thin line) were 83.9 and 53.6%, respectively (p = 0.39).
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Figure 2: The results of Kaplan-Meier analyses of the OS of patients stratified by histology, pathological response and downstaging. a The 5-year OS rate in both the non-SQ (thin line) and SQ (thick line) patients was 77.8%. b The 5-year OS rates in the Ef1–2 (thick line) and Ef3 (thin line) patients were 72.7 and 81.9%, respectively (p = 0.55). c The 5-year OS rates in the patients with downstaging (thick line) and without downstaging (thin line) were 83.9 and 53.6%, respectively (p = 0.39).

Mentions: The global 5-year overall survival (OS) rate was 77.8% in the present series (fig. 1a); the 5-year OS rates in the patients with complete resection (n = 33) and in those with stage III cancer were 83.3% (fig. 1b) and 79.9% (fig. 1c), respectively; the 5-year OS rate in both the non-SQ and SQ patients was 77.8% (fig. 2a); the 5-year OS rates in the patients with Ef1–2 and Ef3 response were 72.7 and 81.9%, respectively (p = 0.55) (fig. 2b), and the 5-year OS rates in the patients with and without downstaging were 83.9 and 53.6%, respectively (p = 0.39) (fig. 2c).


The long-term outcomes of induction chemoradiotherapy followed by surgery for locally advanced non-small cell lung cancer.

Uramoto H, Akiyama H, Nakajima Y, Kinoshita H, Inoue T, Kurimoto F, Nishimura Y, Saito Y, Sakai H, Kobayashi K - Case Rep Oncol (2014)

The results of Kaplan-Meier analyses of the OS of patients stratified by histology, pathological response and downstaging. a The 5-year OS rate in both the non-SQ (thin line) and SQ (thick line) patients was 77.8%. b The 5-year OS rates in the Ef1–2 (thick line) and Ef3 (thin line) patients were 72.7 and 81.9%, respectively (p = 0.55). c The 5-year OS rates in the patients with downstaging (thick line) and without downstaging (thin line) were 83.9 and 53.6%, respectively (p = 0.39).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4255996&req=5

Figure 2: The results of Kaplan-Meier analyses of the OS of patients stratified by histology, pathological response and downstaging. a The 5-year OS rate in both the non-SQ (thin line) and SQ (thick line) patients was 77.8%. b The 5-year OS rates in the Ef1–2 (thick line) and Ef3 (thin line) patients were 72.7 and 81.9%, respectively (p = 0.55). c The 5-year OS rates in the patients with downstaging (thick line) and without downstaging (thin line) were 83.9 and 53.6%, respectively (p = 0.39).
Mentions: The global 5-year overall survival (OS) rate was 77.8% in the present series (fig. 1a); the 5-year OS rates in the patients with complete resection (n = 33) and in those with stage III cancer were 83.3% (fig. 1b) and 79.9% (fig. 1c), respectively; the 5-year OS rate in both the non-SQ and SQ patients was 77.8% (fig. 2a); the 5-year OS rates in the patients with Ef1–2 and Ef3 response were 72.7 and 81.9%, respectively (p = 0.55) (fig. 2b), and the 5-year OS rates in the patients with and without downstaging were 83.9 and 53.6%, respectively (p = 0.39) (fig. 2c).

Bottom Line: Induction chemoradiotherapy followed by surgery for LA-NSCLC provided a favorable prognosis for selected patients.A complete pathological response was found in about half of cases.This strategy is feasible and was associated with low morbidity and high resectability rates, suggesting that it contributed to improving the treatment results.

View Article: PubMed Central - PubMed

Affiliation: Division of Thoracic Surgery, Saitama Cancer Center, Saitama, Hidaka, Japan.

ABSTRACT

Background: Although the concept of induction therapy followed by surgical resection for locally advanced non-small cell lung cancer (LA-NSCLC) has found general acceptance, the appropriate indications and the strategy for this treatment are still controversial.

Methods: From 2000 through 2008, 36 patients received concurrent chemoradiotherapy followed by surgery. We retrospectively reviewed these cases, analyzed the outcomes and examined the prognosis.

Results: The median radiation dose given was 60 Gy. Chemotherapy included a platinum agent in all cases; cisplatin-based chemotherapy was administered to 9 cases, and a carboplatin-based chemotherapy regimen was administered to 27. A complete resection was performed in 94% of the patients. Seventeen (47.2%) patients exhibited a complete pathological response, and downstaging was induced in 26 (72%) cases. The morbidity and 30-day mortality rates were 11.1 and 0%, respectively. The 5-year overall survival rate in the patients with complete resection (n = 33) was 83.3%.

Conclusions: Induction chemoradiotherapy followed by surgery for LA-NSCLC provided a favorable prognosis for selected patients. A complete pathological response was found in about half of cases. This strategy is feasible and was associated with low morbidity and high resectability rates, suggesting that it contributed to improving the treatment results.

No MeSH data available.


Related in: MedlinePlus