Preoperative concurrent chemoradiotherapy for unresectable stage III nonsmall cell lung cancer

David M. Milstein, Abraham Kuten, Milton Saute, Lael A. Best, Khalid Daoud, Issam Zen-Al-Deen, Janet Dale, Eliezar Robinson

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: We carried out a Phase II trial in an attempt to improve resectability and survivability of inoperable Stage III A and III B nonsmall cell lung cancer (NSCLC) patients by implementing a neoadjuvant chemoradiotherapy treatment program. Methods and Materials: Thirty-six patients with locally advanced Stage III NSCLC received neoadjuvant therapy consisting of 50.4 Gy in 5.5 weeks concurrent with two cycles of chemotherapy, using cisplatin and etoposide. No postsurgical consolidation therapy was given. Results: Assessment at 3 to 6 weeks after treatment suggested that 26 (72%) patients had been rendered resectable. Toxicities were common but usually tolerable; however, one toxic death occurred. Of 24 patients who proceeded to thoracotomy, complete resection was achieved in 20 (56%). There were two surgically related deaths. Surgical-pathological staging showed downstaging in 18 patients, including complete sterilization of the tumor in 3 (8%). The median survival for all 36 patients is 15 months, but at the time of analysis, median survival of resectable patients had not been reached. The actuarial 2-year survival is 39% for all study groups, 57% for resectable patients, and 16% for the remaining (p < 0.005). Conclusions: While this preoperative neoadjuvant appears to improve survival of patients with Stage III NSCLC, comparison with previous reports of other similar trials indicate a superior survival advantage in association with higher doses of radiotherapy.

Original languageEnglish (US)
Pages (from-to)1125-1132
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume34
Issue number5
DOIs
StatePublished - Mar 15 1996
Externally publishedYes

Fingerprint

Chemoradiotherapy
Non-Small Cell Lung Carcinoma
lungs
cancer
Neoadjuvant Therapy
Survival
death
therapy
Poisons
consolidation
Etoposide
Thoracotomy
chemotherapy
Survival Analysis
toxicity
Cisplatin
radiation therapy
Radiotherapy
tumors
Drug Therapy

Keywords

  • Neoadjuvant
  • NSCLC
  • Radiochemotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Preoperative concurrent chemoradiotherapy for unresectable stage III nonsmall cell lung cancer. / Milstein, David M.; Kuten, Abraham; Saute, Milton; Best, Lael A.; Daoud, Khalid; Zen-Al-Deen, Issam; Dale, Janet; Robinson, Eliezar.

In: International Journal of Radiation Oncology Biology Physics, Vol. 34, No. 5, 15.03.1996, p. 1125-1132.

Research output: Contribution to journalArticle

Milstein, David M. ; Kuten, Abraham ; Saute, Milton ; Best, Lael A. ; Daoud, Khalid ; Zen-Al-Deen, Issam ; Dale, Janet ; Robinson, Eliezar. / Preoperative concurrent chemoradiotherapy for unresectable stage III nonsmall cell lung cancer. In: International Journal of Radiation Oncology Biology Physics. 1996 ; Vol. 34, No. 5. pp. 1125-1132.
@article{bca2ac3c992843db8df849623f7e0399,
title = "Preoperative concurrent chemoradiotherapy for unresectable stage III nonsmall cell lung cancer",
abstract = "Purpose: We carried out a Phase II trial in an attempt to improve resectability and survivability of inoperable Stage III A and III B nonsmall cell lung cancer (NSCLC) patients by implementing a neoadjuvant chemoradiotherapy treatment program. Methods and Materials: Thirty-six patients with locally advanced Stage III NSCLC received neoadjuvant therapy consisting of 50.4 Gy in 5.5 weeks concurrent with two cycles of chemotherapy, using cisplatin and etoposide. No postsurgical consolidation therapy was given. Results: Assessment at 3 to 6 weeks after treatment suggested that 26 (72{\%}) patients had been rendered resectable. Toxicities were common but usually tolerable; however, one toxic death occurred. Of 24 patients who proceeded to thoracotomy, complete resection was achieved in 20 (56{\%}). There were two surgically related deaths. Surgical-pathological staging showed downstaging in 18 patients, including complete sterilization of the tumor in 3 (8{\%}). The median survival for all 36 patients is 15 months, but at the time of analysis, median survival of resectable patients had not been reached. The actuarial 2-year survival is 39{\%} for all study groups, 57{\%} for resectable patients, and 16{\%} for the remaining (p < 0.005). Conclusions: While this preoperative neoadjuvant appears to improve survival of patients with Stage III NSCLC, comparison with previous reports of other similar trials indicate a superior survival advantage in association with higher doses of radiotherapy.",
keywords = "Neoadjuvant, NSCLC, Radiochemotherapy",
author = "Milstein, {David M.} and Abraham Kuten and Milton Saute and Best, {Lael A.} and Khalid Daoud and Issam Zen-Al-Deen and Janet Dale and Eliezar Robinson",
year = "1996",
month = "3",
day = "15",
doi = "10.1016/0360-3016(95)02263-5",
language = "English (US)",
volume = "34",
pages = "1125--1132",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Preoperative concurrent chemoradiotherapy for unresectable stage III nonsmall cell lung cancer

AU - Milstein, David M.

AU - Kuten, Abraham

AU - Saute, Milton

AU - Best, Lael A.

AU - Daoud, Khalid

AU - Zen-Al-Deen, Issam

AU - Dale, Janet

AU - Robinson, Eliezar

PY - 1996/3/15

Y1 - 1996/3/15

N2 - Purpose: We carried out a Phase II trial in an attempt to improve resectability and survivability of inoperable Stage III A and III B nonsmall cell lung cancer (NSCLC) patients by implementing a neoadjuvant chemoradiotherapy treatment program. Methods and Materials: Thirty-six patients with locally advanced Stage III NSCLC received neoadjuvant therapy consisting of 50.4 Gy in 5.5 weeks concurrent with two cycles of chemotherapy, using cisplatin and etoposide. No postsurgical consolidation therapy was given. Results: Assessment at 3 to 6 weeks after treatment suggested that 26 (72%) patients had been rendered resectable. Toxicities were common but usually tolerable; however, one toxic death occurred. Of 24 patients who proceeded to thoracotomy, complete resection was achieved in 20 (56%). There were two surgically related deaths. Surgical-pathological staging showed downstaging in 18 patients, including complete sterilization of the tumor in 3 (8%). The median survival for all 36 patients is 15 months, but at the time of analysis, median survival of resectable patients had not been reached. The actuarial 2-year survival is 39% for all study groups, 57% for resectable patients, and 16% for the remaining (p < 0.005). Conclusions: While this preoperative neoadjuvant appears to improve survival of patients with Stage III NSCLC, comparison with previous reports of other similar trials indicate a superior survival advantage in association with higher doses of radiotherapy.

AB - Purpose: We carried out a Phase II trial in an attempt to improve resectability and survivability of inoperable Stage III A and III B nonsmall cell lung cancer (NSCLC) patients by implementing a neoadjuvant chemoradiotherapy treatment program. Methods and Materials: Thirty-six patients with locally advanced Stage III NSCLC received neoadjuvant therapy consisting of 50.4 Gy in 5.5 weeks concurrent with two cycles of chemotherapy, using cisplatin and etoposide. No postsurgical consolidation therapy was given. Results: Assessment at 3 to 6 weeks after treatment suggested that 26 (72%) patients had been rendered resectable. Toxicities were common but usually tolerable; however, one toxic death occurred. Of 24 patients who proceeded to thoracotomy, complete resection was achieved in 20 (56%). There were two surgically related deaths. Surgical-pathological staging showed downstaging in 18 patients, including complete sterilization of the tumor in 3 (8%). The median survival for all 36 patients is 15 months, but at the time of analysis, median survival of resectable patients had not been reached. The actuarial 2-year survival is 39% for all study groups, 57% for resectable patients, and 16% for the remaining (p < 0.005). Conclusions: While this preoperative neoadjuvant appears to improve survival of patients with Stage III NSCLC, comparison with previous reports of other similar trials indicate a superior survival advantage in association with higher doses of radiotherapy.

KW - Neoadjuvant

KW - NSCLC

KW - Radiochemotherapy

UR - http://www.scopus.com/inward/record.url?scp=0029991348&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029991348&partnerID=8YFLogxK

U2 - 10.1016/0360-3016(95)02263-5

DO - 10.1016/0360-3016(95)02263-5

M3 - Article

VL - 34

SP - 1125

EP - 1132

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 5

ER -