Multimodality therapy for stage IIIA (N2) lung cancer. An overview.
Disappointing results of surgery and postoperative adjuvant chemotherapy or chemoradiotherapy in stage IIIA (N2) lung cancer have led to a number of phase II trials of induction (neoadjuvant) chemotherapy given prior to surgery. Preliminary results of 2 such studies indicate that mitomycin, vinca alkaloid, and platinum (MVP) given before surgical excision induces an overall response rate of 70% (9 complete responses and 71 partial responses in 112 patients). Of 80 patients who ultimately underwent surgery, complete resection was achieved in 62 (55%). Survival data reflect a median survival of 19.5 months for the entire cohort of 112 patients and 27 months for those who had complete resection. The 5-year-survival rate is expected to reach 15%. Randomized trials are now under way to establish whether this aggressive approach to therapy represents the most appropriate form of treatment for patients with stage IIIA (N2) lung cancer.
Cornell University Medical Center, New York.
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Ginsberg
D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D015996:Survival Rate