Preoperative Chemotherapy Versus Preoperative Chemoradiotherapy for Stage III (N2) Non–Small-Cell Lung Cancer
In: International Journal of Radiation Oncology, Biology, Physics, Jg. 75 (2009-12-01), Heft 5, S. 1462-1467
academicJournal
Zugriff:
Purpose: To compare preoperative chemotherapy (ChT) and preoperative chemoradiotherapy (ChT-RT) in operable Stage III non–small-cell lung cancer. Methods and Materials: This retrospective study analyzed all patients with pathologically confirmed Stage III (N2) non–small-cell lung cancer who initiated preoperative ChT or ChT-RT at Duke University between 1995 and 2006. Mediastinal pathologic complete response (pCR) rates were compared using a chi-square test. The actuarial overall survival, disease-free survival, and local control were estimated using the Kaplan-Meier method and compared using the log–rank test. Multivariate Cox regression analysis was also performed. Results: A total of 101 patients who initiated preoperative therapy with planned resection were identified. The median follow-up was 20 months for all patients and 38 months for survivors. The mediastinal lymph nodes were reassessed after preoperative therapy in 88 patients (87%). Within this group, a mediastinal pCR was achieved in 35% after preoperative ChT vs. 65% after preoperative ChT-RT (p = 0.01). Resection was performed in 69% after ChT and 84% after ChT-RT (p = 0.1). For all patients, the overall survival, disease-free survival, and local control rate at 3 years was 40%, 27%, and 66%, respectively. No statistically significant differences were found in the clinical endpoints between the ChT and ChT-RT subgroups. On multivariate analysis, a mediastinal pCR was associated with improved disease-free survival (p = 0.03) and local control (p = 0.03), but not overall survival (p = 0.86). Conclusion: Preoperative ChT-RT was associated with higher mediastinal pCR rates but not improved survival. [Copyright &y& Elsevier]
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Preoperative Chemotherapy Versus Preoperative Chemoradiotherapy for Stage III (N2) Non–Small-Cell Lung Cancer
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Autor/in / Beteiligte Person: | Higgins, Kristin ; Chino, Junzo P. ; Marks, Lawrence B. ; Ready, Neal ; D'Amico, Thomas A. ; Clough, Robert W. ; Kelsey, Chris R. |
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Zeitschrift: | International Journal of Radiation Oncology, Biology, Physics, Jg. 75 (2009-12-01), Heft 5, S. 1462-1467 |
Veröffentlichung: | 2009 |
Medientyp: | academicJournal |
ISSN: | 0360-3016 (print) |
DOI: | 10.1016/j.ijrobp.2009.01.069 |
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