Preoperative concurrent chemoradiotherapy with cisplatin and docetaxel in patients with locally advanced non-small-cell lung cancer

• Published in: British journal of cancer 2004-03, Vol.90 (5), p.979-984
• Main Authors: Katayama, H, Ueoka, H, Kiura, K, Tabata, M, Kozuki, T, Tanimoto, M, Fujiwara, T, Tanaka, N, Date, H, Aoe, M, Shimizu, N, Takemoto, M, Hiraki, Y
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer Research; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - radiotherapy; Carcinoma, Non-Small-Cell Lung - surgery; Cisplatin - administration & dosage; Clinical; Combined Modality Therapy; Docetaxel; Drug Resistance; Epidemiology; Feasibility Studies; Female; Humans; Lung cancer; Lung Neoplasms - drug therapy; Lung Neoplasms - radiotherapy; Lung Neoplasms - surgery; Male; Medical sciences; Middle Aged; Molecular Medicine; Neoplasm Recurrence, Local; Oncology; Pleural Effusion - etiology; Pneumology; Postoperative Complications; Preoperative Care; Survival Rate; Taxoids - administration & dosage; Tumors of the respiratory system and mediastinum
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6601624

The objective of this study was to assess the feasibility and effectiveness of an induction chemoradiotherapy regimen followed by surgery in patients with locally advanced non-small-cell lung cancer (LA-NSCLC). A total of 22 patients with LA-NSCLC were treated with induction chemoradiotherapy consisting of cisplatin (40 mg m −2 ) and docetaxel (40 mg m −2 ) given on days 1, 8, 29 and 36 plus concurrent thoracic irradiation at a dose of 40–60 Gy (2 Gy fraction −1  day −1 ). Surgical resection was performed within 6 weeks after completion of induction therapy. Objective response to the induction therapy was obtained in 16 patients (73%). In all, 20 patients (91%) underwent surgery and complete resection was achieved in 19 patients (86%). Pathological downstaging and pathological complete response were obtained in 14 (64%) and five (23%) patients, respectively. With a median follow-up period of 32 months, the calculated 3-year overall and progression-free survival rates were 66 and 61%, respectively. It is noteworthy that the 3-year overall survival rate in 14 patients achieving pathological downstaging was extremely high (93%). Toxicity was manageable with standard approaches. No treatment-related deaths occurred. This combined modality treatment is feasible and highly effective in patients with LA-NSCLC. The results warrant further large-scale study to confirm the effectiveness of this regimen.