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What outcome after the prescription of neoadjuvant chemotherapy in lung cancer?

AbstractBACKGROUND:
The treatment of patients with locally advanced non-small-cell lung cancer is controversial. Surgery remains the gold standard, even in this group. Neoadjuvant chemotherapy could allow surgical resection in patients initially judged inoperable.
METHODS:
From January 2009 to May 2010, neoadjuvant chemotherapy was indicated in 27 patients with NSCLC (25 men, 2 women). Their mean age was 65 years. The stages were: IIB in 5, IIIA in 17 (6 in stage IIIAN2), IIIB in 2, and IV in 3.
RESULTS:
23 patients received neoadjuvant chemotherapy, 2 refused induction treatment, and 2 had impaired status. The neoadjuvant chemotherapy regimen was gemcitabine-cisplatin in 17 patients and vinorelbine-cisplatin in 6. Only 5 patients underwent complete surgical treatment after induction: 1 in stage IIB, 1 in stage IIIAN0, 1 in IIIB, and 2 in stage IV (1 operated brain metastasis, and 1 operated adrenal metastasis). Surgical treatment was not achieved after neoadjuvant chemotherapy in 18 patients because of progressive disease.
CONCLUSION:
Neoadjuvant chemotherapy offers several potential benefits, but it may delay surgery or eliminate eligibility as a surgical candidate. Rigorous patient selection for this type of multimodal treatment is essential.
AuthorsMohamed-Sadok Boudaya, Hanène Smadhi, Adel Marghli, Fatma Charmiti, Sonia Ouerghi, Jalel Mohamed, Emna Brahem, Belhassen Smati, Taher Mestiri, Tarek Kilani
JournalAsian cardiovascular & thoracic annals (Asian Cardiovasc Thorac Ann) Vol. 21 Issue 4 Pg. 432-6 (Aug 2013) ISSN: 1816-5370 [Electronic] England
PMID24570525 (Publication Type: Journal Article)
Chemical References
  • Deoxycytidine
  • Vinblastine
  • Cisplatin
  • Vinorelbine
  • Gemcitabine
Topics
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Carcinoma, Non-Small-Cell Lung (drug therapy, pathology, surgery)
  • Chemotherapy, Adjuvant
  • Cisplatin (administration & dosage)
  • Deoxycytidine (administration & dosage, analogs & derivatives)
  • Disease Progression
  • Female
  • Humans
  • Lung Neoplasms (drug therapy, pathology, surgery)
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Patient Selection
  • Pneumonectomy
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Vinblastine (administration & dosage, analogs & derivatives)
  • Vinorelbine
  • Gemcitabine

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