Recently, results from IALT, JBR10 and CALGB9633 showed that postoperative
adjuvant chemotherapy improved survival rate of patients with
non-small cell lung cancer (NSCLC) after complete resection. The aim of this study is to evaluate the effect of postoperative
adjuvant chemotherapy on survival after complete resection for stage IIIA-N2 NSCLC.
METHODS: RESULTS: In the
chemotherapy group, 86.1% (68/79) of patients finished 4 cycles of
chemotherapy, and no one died of toxic effects of
chemotherapy; 25% of patients had grade III-IV
leukopenia, 2% of patients had febrile
leukopenia. The median survival time for the entire 150 patients was 879 days, and 1-, 2- and 3-year survival rate was 81%, 59% and 43%. There was no significant difference in median survival between the
chemotherapy and observation groups (P= 0.0527), but there was significant difference in the 1- and 2-year survival rate (94.71% and 76.28% vs 88.24% and 60.13%, P < 0.05). The most common site of recurrence was the brain. Twenty-six percent (39/150) of patients recurred in the brain as their first site of failure, and 22.8% (18/79) for the
chemotherapy group, 29.6% (21/71) for the observation group. The median survival time for patients who developed brain
metastasis was not significantly different between the
chemotherapy and observation groups (812 days vs 512 days, P=0.122), but there was significant difference in the 2-year survival rate (66.7% vs 37.6%, P < 0.01). The median survival was 190 days for the patients since brain
metastasis appeared.
CONCLUSIONS: Postoperative
adjuvant chemotherapy dose not significantly improve median survival among patients with completely resected stage IIIA-N2 NSCLC, but significantly improves the 1- and 2-year survival rate. It also dose not decrease the incidence of brain
metastasis but puts off the time of brain
metastasis.