title: Intermittent adjuvant chemo-immunotherapy after resection of non-small cell lung cancer with multilevel mediastinal lymph node metastasis.
abstract: The prognosis of patients with multilevel mediastinal lymph node metastasis remains poor notwithstanding the progress in multimodal therapy in non-small cell lung cancer. We conducted a feasible study of intermittent adjuvant chemo-immunotherapy after surgery for patients with multilevel mediastinal lymph node metastasis of non-small cell lung cancer. Eleven patients with pathologically N2 or N3 lung cancer (10, adenocarcinomas; 1, squamous cell carcinoma) were enrolled. Five completely resected cases received systemic chemo-immunotherapy and six incompletely resected cases received local chemo-immunotherapy by an indwelling catheter in the thoracic cavity. Cisplatin-based and dose-dependent anti-cancer drugs were selected on the basis of sensitivity tests. Either adoptive immunotherapy with interleukin-2 and lymphokine-activated killer cell or combination of interferon gamma# and OK432 were administered after chemotherapy. This adjuvant therapy was performed every 2-3 months after surgery for 2 years. The 2-year survival rate for all cases were 72.7% and the 2-year disease-free survival were 36.4%. The 2-year survival rate for five completely resected cases and six incompletely resected cases was 80% and 66.7%, respectively. Combined intermittent chemo-immunotherapy after surgical resection of tumors may be a promising modality to improve the survival of patients with multilevel mediastinal lymph node metastasis in non-small cell lung cancer.
authors.affiliation: Department of Surgery, Institute of Pulmonary Cancer Research, Chiba University School of Medicine, Chuo-ku, Chiba 260-8677, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Suzuki
authors.forename: H
authors.initials: H
authors.lastname: Kimura
authors.forename: N
authors.initials: N
authors.lastname: Iwai
authors.forename: T
authors.initials: T
authors.lastname: Fujisawa
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007167:Immunotherapy; D016219:Immunotherapy, Adoptive; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D014751:Vindesine / Q000008:administration & dosage
chemical_list: D016685:Mitomycin; D002945:Cisplatin; D014751:Vindesine