Phase II Trial of Preoperative Chemoradiotherapy Followed by Surgical Resection in Patients With Superior Sulcus Non–Small-Cell Lung Cancers: Report of Japan Clinical Oncology Group Trial 9806

Kunitoh, Hideo; Kato, Harubumi; Tsuboi, Masahiro; Shibata, Taro; Asamura, Hisao; Ichonose, Yukito; Katakami, Nobuyuki; Nagai, Kanji; Mitsudomi, Tetsuya; Matsumura, Akira; Nakagawa, Ken; Tada, Hirohito; Saijo, Nagahiro

doi:10.1200/jco.2007.14.1911

Cited by 176 publications

(143 citation statements)

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“…[6][7][8] We previously used cisplatin and vindesine in the 1990s, and then changed vindesine to vinorelbine in the 2000s. Chemotherapy regimens with new agents, including paclitaxel, docetaxel, and gemcitabine, have recently been reported to be effective for advanced NSCLC.…”

Section: Discussionmentioning

confidence: 99%

“…Patients received 2 cycles of chemotherapy every 4 weeks as follows: PV(M) regimen, cisplatin 80 mg/m 2 on day 1 and vindesine 3 mg/m 2 on days 1 and 8 with or without mitomycin 8 mg/ m 2 on day 1 according to the protocol of Japan Clinical Oncology Group 9209 and 9806 6,7) ; nPV regimen, cisplatin 80 mg/m 2 on day 1 and vinorelbine 20 mg/m 2 on days 1 and 8 every 4 weeks according to the protocol described by Naito et al 8) Radiotherapy directed at the tumor and mediastinal nodes was started on day 2 concurrently in cycle 1 and the total radiation dose was 40 Gy in 20 fractions administered over 4 weeks. For poor responding patients (n = 10), an additional dose of 10 to 20 Gy was administered.…”

Section: Methodsmentioning

confidence: 99%

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Pathological Status of Mediastinal Lymph Nodes after Preoperative Concurrent Chemoradiotherapy Determines Prognosis in Patients with Non-Small Cell Lung Cancer

Shintani

Funakoshi

Inoue

et al. 2012

ATCS

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Objectives: The benefits of preoperative chemoradiotherapy for advanced nonsmall cell lung cancer (NSCLC) remain controversial. To evaluate prognostic indicators of clinical N2 NSCLC patients treated with concurrent chemotherapy followed by pulmonary resection, we performed a retrospective study. Methods: We retrospectively investigated 52 patients with pathologically proven N2 NSCLC who underwent concurrent chemoradiotherapy before pulmonary resection. Each received 2 cycles of cisplatin-vinca alkaloid-based chemotherapy every 4 weeks. Radiotherapy, directed at the tumor and mediastinal nodes, was started on day 2 at a median dose of 44 Gy. A thoracotomy was performed 6 to 8 weeks after completion of chemoradiotherapy. Results: The overall 5-year survival rate for the 52 patients was 38%. Complete pathological response by the tumor was found in 11 (21%). Down-staging of nodal stage occurred in 29 patients, (56%) and overall survival was better in those with lower pathological N status. The 5-year survival rate was 58% for pathological N0-N1 disease and 0% for N2 disease. While the response to induction therapy by the primary tumor was correlated with postoperative nodal stage, multivariate analysis revealed postoperative nodal stage as an independent prognostic factor. Conclusion: Pathological status of mediastinal lymph nodes in response to preoperative concurrent chemoradiotherapy determined prognosis in our patients.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Pathological Status of Mediastinal Lymph Nodes after Preoperative Concurrent Chemoradiotherapy Determines Prognosis in Patients with Non-Small Cell Lung Cancer

Shintani

Funakoshi

Inoue

et al. 2012

ATCS

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“…ACCP and NCCN guidelines advised induction chemo-radiotherapy followed by resection for the treatment of Pancoast carcinomas [9,10]. The mortality rate of this kind of multimodality therapies ranges from 1.3% to 2.7% [11,12]. It is important to make differential diagnosis of the Pancoast carcinoma from other rare conditions that are located in the lung apex that can cause similar appearance and symptoms.…”

Section: Discussionmentioning

confidence: 99%

Schwannoma and Paraganglioma: Rare Causes of Pancoast Tumors With Increased FDG Uptake on Pet/Ct

Biner

Tatci

Özmen

et al. 2016

Osmangazi̇ Journal of Medicine

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Pancoast tumors are the masses that are located at the apical region of the lungs and may cause some typical symptoms, named as Pancoast Syndrome, like shoulder and arm pain, Horner's syndrome (ipsilateral ptosis, myosis, enophthalmus and anhydrosis) and weakness in ipsilateral hand musculature due to the invasion of the adjacent nerves and bone. These tumors are commonly the malign lung carcinomas. Here we report two cases of patients suffering from back and arm pain and that have some pancoast syndrome symptoms mentioned above, related to apical mass in radiological images. One of these patients had ptosis and anhydrosis associated with Horner's syndrome. 2-Deoxy-2-[18F] Fluoro-D-Glucose (FDG) with positron emission tomography/computerized tomography (PET/CT)was performed because of a suspicion of malignancy and an intense FDG accumulation was seen coincident with the apical tumor in both. The patients then underwent complete surgical resection of the mass and the masses were postoperatively diagnosed as paraganglioma and schwannoma, respectively. So, we wanted to emphasize that neurogenic tumors should be included in the differential diagnosis of Pancoast tumor as a rare cause and to remind the clinicians to give their attentions for essentiality of tissue diagnosis of Pancoast carcinoma before starting the treatment.

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“…A tüdőreszekció mértéke (lobectomia vs. bilobectomia vs. pneumectomia) nem játszik bizonyí-tottan döntő szerepet az incidencia alakulásában [4]. Nem tisztázott továbbá a neoadjuváns, különösen az irradiáció prediktív értéke sem a ChTX kialakulásában; Pancoast-tumoros betegek esetében, neoadjuváns kezelést és műtétet követően, a ChTX-incidencia nem haladta meg a már ismertetett világirodalmi átlagot [12].…”

Section: Kóroki Megoszlásunclassified

A chylothorax modern kezelésének bizonyítékalapú áttekintése

2016

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A chylothorax napjainkban rendszerint műtéti vagy baleseti szövődmény, ritkábban daganat következménye. Prospektív vagy randomizált vizsgálatok hiányában a bizonyítékalapú kezelés személyes tapasztalaton, ideálisan a retrospektív elemzések ismeretében történik. A szerzők célja a chylothorax modern kezelésének áttekintése. A PubMed adatbázist "chylothorax" kulcsszóra szűrték az elmúlt tíz év közleményei között, kiemelve az összehasonlító értéke-léseket. A módszerek és ajánlások kritikai elemzésekor a szerzők együttes 39 éves klinikai tapasztalatukra támaszkod-tak. A konzervatív kezelés sikere az etiológiától függően nagy szórást mutat (3-90%). A non-és szemi-invazív intervenciós eljárások sikerrátája 50-100% közötti. Eredménytelen konzervatív kezeléskor a sebészi kezelés, elsősorban a ductus thoracicus lekötése jelenti a standard terápiát. Ezen beavatkozások sikerességi aránya 64-100% közötti, a morbiditási/mortalitási mutató elérheti a 25%-ot. A kezelést konzervatívan kell megkezdeni, majd egy lépcsőzetes agresszivitású terápia ajánlott, amelyben a beteg állapota és a drénvolumen irányítják a döntéshozatalt. Az intervenciós radiológiai eljárások biztonságosak, sikeresek és helyet kaptak a konzervatív és műtéti megoldások mellett. Orv. Hetil., 2016, 157(2), 43-51. Kulcsszavak: chylothorax, szövődmény, mellkassebészet Review of evidence-based modern treatment for chylothoraxChylothorax is a multi-factorial complication, frequently of an operation or an accident, but rarely of a tumour. In the absence of prospective or randomised studies evidence-based treatment is normally based on personal experience, ideally in the possession of retrospective analyses using the "best practice" method. The aim of the authors was the review the up-to-date chylothorax treatments. They performed the PubMed database's "chylothorax" keyword search of the publications reported in the last ten years. They put emphasis on articles that included a comparative analysis of the various treatment options. During the critical analysis of the methods and recommendations, the authors relied on their own joint experience amounting to 39 years. The results showed that the success of the initial conservative treatment indicates a signifi cant deviation depending on the etiology (3-90%). The success rate of noninvasive or semi-invasive interventions is between 50-100%, again depending on the etiology. The standard surgical treatment following an unsuccessful conservative treatment of an operable patient includes the fi tting of a (thoracoscopic) knot to the ductus thoracicus, pleurodesis, insertion of a permanent chest drain or a pleuroperitoneal shunt. The success rate of these interventions is between 64-100%, with a morbidity index and mortality index exceeding 25%. Conservative treatment should be the fi rst step, which should then be followed by a gradually increased aggressive therapy, during which the decisions should be made according to the patient's condition and the drain volume. Interventional radiology procedures are safe, successful an...

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Phase II Trial of Preoperative Chemoradiotherapy Followed by Surgical Resection in Patients With Superior Sulcus Non–Small-Cell Lung Cancers: Report of Japan Clinical Oncology Group Trial 9806

Abstract: This trimodality approach is safe and effective for the treatment of patients with SSTs.

Cited by 176 publications

References 32 publications

Pathological Status of Mediastinal Lymph Nodes after Preoperative Concurrent Chemoradiotherapy Determines Prognosis in Patients with Non-Small Cell Lung Cancer

Pathological Status of Mediastinal Lymph Nodes after Preoperative Concurrent Chemoradiotherapy Determines Prognosis in Patients with Non-Small Cell Lung Cancer

Schwannoma and Paraganglioma: Rare Causes of Pancoast Tumors With Increased FDG Uptake on Pet/Ct

A chylothorax modern kezelésének bizonyítékalapú áttekintése

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