Neoadjuvant treatment followed by surgery versus definitive chemoradiation in stage IIIA-N2 non-small-cell lung cancer: A multi-institutional study by the oncologic group for the study of lung cancer (Spanish Radiation Oncology Society)

Abstract

The findings reported here indicate that neoadjuvant chemotherapy or chemoradiotherapy followed by surgery (preferably lobectomy) yields better OS and PFS than definitive chemoradiotherapy in patients with resectable stage IIIA-N2 NSCLC.

Evaluation of prognostic factors in lung cancers with surgical complete response after induction treatment

“…Kim et al [31] 2011 233 52 22.3 CHT+RT (total dose: 43 Gy) 58 Lococo et al [10] 2012 137 37 27 CHT+RT (total dose: 50 Gy) 64 Mouillet et al [19] 2012 492 41 8.3 CHT alone 80 Pless et al [17] 2015 232 27 11.6 CHT alone (51%). CHT+RT (49%) (total dose: 44 Gy) N/A Counago et al [18] 2018 247 32 13 CHT alone (52.5%) + CHT+RT (47.4%) (total dose 44-66 Gy)…”

“…CHT+RT (80%) (total dose: 45 Gy) 56 Kim et al [ 31 ] 2011 233 52 22.3 CHT+RT (total dose: 43 Gy) 58 Lococo et al [ 10 ] 2012 137 37 27 CHT+RT (total dose: 50 Gy) 64 Mouillet et al [ 19 ] 2012 492 41 8.3 CHT alone 80 Pless et al [ 17 ] 2015 232 27 11.6 CHT alone (51%). CHT+RT (49%) (total dose: 44 Gy) N/A Counago et al [ 18 ] 2018 247 32 13 CHT alone (52.5%) + CHT+RT (474%) (total dose 44-66 Gy) N/A Melek et al [ 22 ] 2019 416 72 17.3 CHT alone (69%). CHT+RT (31%) (45-66 Gy) 72 Current study 2020 187 39 20.8 CHT alone (18%).…”

“…Researchers have suggested that, in patients with locally advanced NSCLC, surgical treatment alone or only oncological treatment have a lower success rate than combined treatment (IT + surgery) in disease control, local or distant recurrence rates, and long-term survival, and despite the related ongoing debate, combined treatments have found their place in clinical practice. [2,5,6,9,[14][15][16][17][18] In the multi-center, randomized study of European Organisation for Research and Treatment of Cancer-08012 (EORTC-08012), combined treatment facilitated, simplified, and reduced surgical treatment by regressing primary cancer and mediastinal involvement, allowed metastases that were undefined at the beginning of treatment to be approachable and dealt with, led to better use of medications before surgery through the vascular integrity of the tumor, and the surgery prevented the possibility of any residual tumor tissue in locally advanced disease. [6] Many studies have shown that, along with IT, better survival rates are obtained with downstaging or pCR.…”

Multidisciplinary consensus statement on the clinical management of patients with stage III non-small cell lung cancer

“…The trials that analyse the role of treatment with induction chemoradiotherapy followed by surgery failed to show a survival benefit except in certain subgroups of patients [74][75][76]. A clinical trial randomised patients with resectable N2 disease (75% a single station affected) to receive a concomitant chemoradiotherapy treatment (radiation dose of 45 Gy + cisplatin-etoposide) followed by surgery or radical radiotherapy (61 Gy).…”

Комбинированное Лечение Больных Немелкоклеточным Раком Легкого

“…Неоадъювантная ПХТ и адъювантная химиолучевая терапия, в качестве компонентов комбинированной терапии, позволяют выполнять органосохраняющие резекции легких в тех случаях, когда пневмонэктомия нежелательна в связи с возможностью возникновения осложнений в послеоперационном периоде. При этом отдаленные результаты и «качество жизни» пациентов не ухудшаются [22,23,24,25,26].…”