Effectiveness and toxicity of preoperative therapy in stage iiia non-small cell lung cancer including the memorial sloan-kettering experience with induction mvp in patients with bulky mediastinal lymph node metastases (Clinical n2)

Mark G. Kris, Katherine M.W. Pisters, Robert J. Ginsberg, James R. Rigas, Vincent A. Miller, Stefan C. Grant, Richard J. Gralla, Robert T. Heelan, Nael Martini

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

The use of preoperative chemotherapy with mitomycin, vinblastine and cisplatin (MVP) has led to improved complete resection rates and survival in Stage IIIA non-small cell lung cancer with bulky, ipsilateral, mediastinal lymph node metastases (Clinical N2 disease). The addition of preoperative irradiation has also been explored with results not substantially different from preoperative cisplatin-based chemotherapy alone. While preoperative chemotherapy has been shown to be feasible, the toxicity of both the chemotherapy and the subsequent resection is of concern with an overall treatment-related mortality of nearly 8%. The careful selection of patients, swift management of neutropenia, and meticulous perioperative pulmonary care has the potential to reduce the mortality from multimodality therapy. Having shown survival benefit in multiple single-institution and randomized trials, induction chemotherapy followed by surgery or irradiation is now the treatment of choice for patients with Stage IIIA non-small cell lung cancer with mediastinal lymph node metastases.

Original languageEnglish (US)
Pages (from-to)S47-S57
JournalLung Cancer
Volume12
Issue numberSUPPL. 1
DOIs
StatePublished - Apr 1995

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Keywords

  • Cisplatin
  • Induction chemotherapy
  • Mediastinal lymph node metastases
  • Multimodality therapy
  • Neoadjuvant chemotherapy
  • Non-small cell lung cancer

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

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