Neoadjuvant chemotherapy of stage III-A and B lung carcinoma using the PACCO regimen.
Previously, we reported an effective chemotherapeutic combination regimen for non-small cell lung carcinoma (NSCLC): cisplatinum, doxorubicin, cyclophosphamide, CCNU, and vincristine (PACCO). Forty-one patients with a diagnosis of NSCLC Stages III-A and III-B were entered into the protocol of neoadjuvant PACCO chemotherapy. Following two courses of chemotherapy, the patients were evaluated for surgical therapy. The overall response rate to the chemotherapy was 60%. Subsequently, 65% of the patients underwent surgical resection. The overall estimated median survival was 18 months. The survival of patients in III-A was 36 months and that of III-B was 18 months (95% confidence lower bounds for III-A: 8 months and for III-B: 13 months). There was one chemotherapy-related mortality but no surgical mortality. Neoadjuvant chemotherapy with PACCO regiment offers an alternative to chemoradiation therapy, without increasing the surgical mortality, and should be validated in a randomized clinical trial. For successful neoadjuvant chemotherapy of Stage III NSCLC, chemotherapy combination which would give a high response rate without significant side effects must be chosen.
Takita
H
H
Department of Thoracic Surgery and Oncology, Division of Surgical Oncology, Buffalo 14263, USA.
Blumenson
L E
LE
Raghavan
D
D
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008130:Lomustine / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000401:mortality; D015996:Survival Rate; D013908:Thoracotomy / Q000401:mortality; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D008130:Lomustine; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin