title: Preoperative chemotherapy and radiation therapy for stage IIIa carcinoma of the lung.
abstract: Thirty-six patients with stage IIIa histologically proven non-small cell carcinoma (T3 N2 or T2 N2) underwent concomitant radiation therapy and chemotherapy before pulmonary resection. The therapy consisted of two cycles of continuous infusion of cis-platinum, 25 mg.m-2.day-1 (days 1 through 4) every 4 weeks and concomitant irradiation, 55 Gy, of the tumor and mediastinum. Two to 3 weeks after treatment, the patients were reevaluated for thoracotomy and pulmonary resection. Five patients were found to have unresectable lesions. Thirty-one patients had complete resection, 27 by radical pneumonectomy and 4 by radical lobectomy, giving a resectability rate of 86%. Complete sterilization of lung tumor and mediastinal nodes proven histologically was achieved in 10 patients (28%) and 17 patients (47%). The 3-year survival rate is 61.7% for patients who had resection. Median follow-up is 27 months (range, 6 to 61 months). The preliminary study indicates that preoperative cis-platinum and concomitant radiation therapy is tolerated, appears to increase resectability, and may improve survival in patients with stage IIIa lung cancer.
authors.affiliation: Division of Thoracic Surgery, Roger Williams Cancer Center, Providence, RI 02908.
authors.forename: J
authors.initials: J
authors.lastname: Yashar
authors.forename: A B
authors.initials: AB
authors.lastname: Weitberg
authors.forename: A S
authors.initials: AS
authors.lastname: Glicksman
authors.forename: M R
authors.initials: MR
authors.lastname: Posner
authors.forename: W
authors.initials: W
authors.lastname: Feng
authors.forename: H J
authors.initials: HJ
authors.lastname: Wanebo
mesh_terms: D000328:Adult; D000368:Aged; D002283:Carcinoma, Bronchogenic / Q000401:mortality / Q000628:therapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate