Preoperative concurrent chemoradiotherapy for unresectable stage III nonsmall cell lung cancer

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

Research output: Contribution to journalArticle

18 Scopus citations

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

Keywords

  • NSCLC
  • Neoadjuvant
  • Radiochemotherapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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    Milstein, D., Kuten, A., Saute, M., Best, L. A., Daoud, K., Zen-Al-Deen, I., Dale, J., & Robinson, E. (1996). Preoperative concurrent chemoradiotherapy for unresectable stage III nonsmall cell lung cancer. International Journal of Radiation Oncology Biology Physics, 34(5), 1125-1132. https://doi.org/10.1016/0360-3016(95)02263-5