Induction chemoradiotherapy (carboplatin-taxane and concurrent 50-Gy radiation) for bulky cN2, N3 non-small cell lung cancer.

Abstract

OBJECTIVE:

To improve the prognosis of cN2, N3 non-small cell lung cancer, we performed induction chemoradiotherapy (carboplatin-taxane chemotherapy and concurrent 50-Gy radiation) followed by surgery.

METHODS:

Patients with pathologically proven non-small cell lung cancer with bulky cN2, N3 disease were enrolled. Forty-one patients underwent an operation after chemoradiotherapy from January 2000 to April 2006. Either carboplatin-paclitaxel (n = 19) or carboplatin-docetaxel (n = 22) chemotherapy was randomly used. Two cycles of chemotherapy were performed with concurrent radiation (50 Gy). In all cases, conventional radiological reevaluations were performed; in the latest 21 cases, reevaluations with positron-emission tomography with fludeoxyglucose F 18 were also performed.

RESULTS:

In all 41 cases, complete resections were performed, with no operative mortality. The histologically complete response rate, major response rate, and minor response rate were 17.1% (7/41), 56.1% (23/41), and 26.8% (11/41), respectively. The 5-year overall survival was 52.7%. There were no differences in survival between taxane groups. Both the complete response and the major response groups revealed a significantly better 5-year survivals than the minor response group (85.7%, P = .044, 52.4%, P = .01). Even with persistent N2 disease, the 5-year survival in the major response group (66%) was promising. With the combination of conventional computed tomography and positron-emission tomography with fludeoxyglucose F 18 for reevaluation, eligible patients could be selected for this protocol.

CONCLUSION:

Surgery after chemoradiotherapy (carboplatin-taxane and 50-Gy radiation) for bulky cN2, N3 non-small cell lung cancer can be safely performed with promising results. Even with persistent N2 disease, the survival in the major response group was promising.

• Authors: Hiroyasu Yokomise, Masashi Gotoh, Taku Okamoto, Yasumichi Yamamoto, Shinya Ishikawa, Takashi Nakashima, Daiki Masuya, Dage Liu, Cheng-long Huang
• Journal: The Journal of thoracic and cardiovascular surgery (J Thorac Cardiovasc Surg) Vol. 133 Issue 5 Pg. 1179-85 (May 2007) ISSN: 1097-685X [Electronic] United States
• PMID: 17467426 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Bridged-Ring Compounds
• Taxoids
• taxane
• Carboplatin

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bridged-Ring Compounds (administration & dosage)
• Carboplatin (administration & dosage)
• Carcinoma, Non-Small-Cell Lung (mortality, pathology, surgery, therapy)
• Female
• Humans
• Lung Neoplasms (mortality, pathology, surgery, therapy)
• Male
• Middle Aged
• Neoadjuvant Therapy
• Radiotherapy Dosage
• Survival Rate
• Taxoids (administration & dosage)