A phase ii trial of combined chemotherapy and surgery in stage iiia non-small cell lung cancer

A poor prognosis for patients with Stage IIIA clinical N2 treated by surgery alone has led clinical researchers to find a new treatment modality to improve the curative potential of surgery. Many Phase II trials have been carried out with induction chemo-or chemo-radiotherapy prior to surgery. From...

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Bibliographic Details
Published in:Lung cancer (Amsterdam, Netherlands) Netherlands), 1995-04, Vol.12, p.S71-S78
Main Authors: Darwish, Samir, Minotti, Vincenzo, Crinó, Lucio, Rossetti, Riccardo, Fiaschini, Paolo, Maranzano, Ernesto, Checcaglini, Franco, Todisco, Tommaso, Giansanti, Michele, Mercati, Ugo, Vitali, Rino, Latini, Paolo, Tonat, Maurizio
Format: Article
Language:English
Subjects:
Aged
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Carcinoma, Non-Small-Cell Lung - drug therapy
Carcinoma, Non-Small-Cell Lung - mortality
Carcinoma, Non-Small-Cell Lung - surgery
Cisplatin
Cisplatin - administration & dosage
Combined Modality Therapy
Etoposide - administration & dosage
Female
Humans
Lung Neoplasms - drug therapy
Lung Neoplasms - mortality
Lung Neoplasms - surgery
Male
Middle Aged
Neoadjuvant chemotherapy
Non-small cell lung cancer
Remission Induction
Survival Rate
Treatment Outcome
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Summary:A poor prognosis for patients with Stage IIIA clinical N2 treated by surgery alone has led clinical researchers to find a new treatment modality to improve the curative potential of surgery. Many Phase II trials have been carried out with induction chemo-or chemo-radiotherapy prior to surgery. From June 1988 to July 1991, 46 patients with non-small cell lung cancer (NSCLC) Stage IIIA clinical N2 entered a Phase II induction-chemotherapy trial. Patients received 2–3 cycles of high-dose cisplatin and etoposide. Forty-five were evaluable for response; the response rate was 82% (37/45: 3 CR, 34 PR). Toxicity was primarily hematologic. Surgical resection was performed in 35 patients; radical resection was possible in 28 patients (62%); three patients were incompletely resected and two patients were only explored. Three deaths were surgery-related. Median survival was 24.5 months with a 2-year survival of 53%. Cisplatin with etoposide is an active and safe induction chemotherapy regimen for NSCLC Stage IIIA N2 with a high response rate. The median survival seems to be prolonged and therefore, randomized trials are needed to compare this approach with other treatment modalities.
ISSN:0169-5002
1872-8332
DOI:10.1016/0169-5002(95)00422-W