Induction chemoradiotherapy and surgical resection for selected stage IIIB non–small-cell lung cancer

Ichinose, Yukito; Fukuyama, Yasuro; Asoh, Hiroshi; Ushijima, Chie; Okamoto, Tatsuro; Ikeda, Jirō; Okamoto, Junichi; Sakai, Motohiro

doi:10.1016/s0003-4975(03)01075-0

Cited by 37 publications

(30 citation statements)

References 11 publications

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“…A previous study using UFT plus cisplatin with concurrent radiotherapy as induction treatment for selected patients with stage IIIB NSCLC indicated that the 1-and 3-year survival rates in all patients were 73% and 56%, respectively. 6 The present study exceeds those results, without any severe toxicities. However, the response rate was 50% in the present study, which seems relatively low compared with other studies.…”

Section: Discussioncontrasting

confidence: 51%

Concurrent chemoradiotherapy using cisplatin plus s-1, an oral fluoropyrimidine, followed by surgery for selected patients with stage III non-small cell lung cancer: A single-center feasibility study

et al. 2011

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Section: Discussioncontrasting

confidence: 51%

Concurrent chemoradiotherapy using cisplatin plus s-1, an oral fluoropyrimidine, followed by surgery for selected patients with stage III non-small cell lung cancer: A single-center feasibility study

et al. 2011

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“…Retrospective series have found a 3-year overall survival of 42-56% in patients with stage IIIB disease undergoing multimodality therapy including surgical resection, and a favorable response to induction therapy appears to be a significant predictor of survival. 9-10 A series of 40 patients with stage IIIB NSCLC by Grunenwald et al noted that those who underwent complete resection and had no lymphatic metastases on final pathology had a 5-year overall survival of 42%. 11 …”

Section: Commentmentioning

confidence: 99%

Role for Surgical Resection in the Multidisciplinary Treatment of Stage IIIB Non–Small Cell Lung Cancer

Bott

Patel

Crabtree

et al. 2015

The Annals of Thoracic Surgery

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Background The role of multi-modality therapy in stage IIIB NSCLC remains inadequately studied. Although chemoradiation is currently the mainstay of treatment, randomized trials evaluating surgery are lacking and resection is offered selectively. Methods Data of clinical stage IIIB NSCLC patients (T4N2 or any N3) undergoing definitive multimodality therapy were obtained from the National Cancer Database (NCDB). Multivariable Cox regression models were fitted to evaluate variables influencing overall survival (OS). Results From 1998-2010, 7,459 clinical stage IIIB NSCLC patients were treated with definitive chemoradiation (CR group), while 1,714 patients underwent chemotherapy, radiation, and surgery in any sequence (CRS group). CRS patients were more likely to be younger, Caucasian, and have slightly smaller tumors (all p < 0.01). There was no difference in Charlson Comorbidity Index (CCI) between the groups (p = 0.5). In the CRS group, 79% of patients received neoadjuvant therapy. Thirty-day surgical mortality was 3%. Factors associated with improved OS in multivariate analysis included younger age, female gender, decreased CCI, smaller tumor size, and surgical resection (HR 0.57, 95% CI 0.52-0.63). Among patients treated with surgery, incomplete resection was associated with decreased OS (HR 1.52, 95% CI 1.20-1.92). Median OS was longer in CRS patients (25.9 months vs. 16.3 months, p<0.001). Propensity matched analysis on 631 patient-pairs treated with CRS vs. CR confirmed these findings (median OS = 28.9 vs. 17.2 months, p<0.001). Conclusions Surgical resection as a part of multimodality therapy may be associated with improved overall survival in highly selected patients with stage IIIB NSCLC. Multidisciplinary evaluation of these patients is critical.

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“…Previously, it has been shown that NSCLC patients with histologically proven N2/N3-status could benefit from neoadjuvant therapy [1,2]. Therefore, mediastinoscopical diagnosis of N2/N3-status may indicate neoadjuvant therapy regimens including chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Detection of disseminated tumor cells in mediastinoscopic lymph node biopsies and lymphadenectomy specimens of patients with NSCLC by quantitative RT-PCR☆

Wang

Sienel

Eggeling

et al. 2005

European Journal of Cardio-Thoracic Surgery

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Induction chemoradiotherapy and surgical resection for selected stage IIIB non–small-cell lung cancer

Cited by 37 publications

References 11 publications

Concurrent chemoradiotherapy using cisplatin plus s-1, an oral fluoropyrimidine, followed by surgery for selected patients with stage III non-small cell lung cancer: A single-center feasibility study

Concurrent chemoradiotherapy using cisplatin plus s-1, an oral fluoropyrimidine, followed by surgery for selected patients with stage III non-small cell lung cancer: A single-center feasibility study

Role for Surgical Resection in the Multidisciplinary Treatment of Stage IIIB Non–Small Cell Lung Cancer

Detection of disseminated tumor cells in mediastinoscopic lymph node biopsies and lymphadenectomy specimens of patients with NSCLC by quantitative RT-PCR☆

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