A randomized trial of postoperative CDDP-based chemotherapy/chemoradiotherapy vs short-term immunochemotherapy in lung cancer.
BACKGROUND
Although a few reports indicated some benefit to survival, the effect of adjuvant therapy for the patients with resected lung cancer was still controversial. The aim of our study was to evaluate survival advantage of CDDP-based adjuvant therapy compared with short-term immunochemotherapy.


METHODS



METHODS
prospective randomized trial.


METHODS
from 1990 through 1994, 94 patients were registered. Forty-seven patients were randomly assigned to each group, i.e., CDDP-based therapy group (CB Group, CDDP+VDS+tegafur+OK-432 or CDDP+OK-432+mediastinal irradiation) or immunochemotherapy group (IC Group, tegafur+OK-432). PATIENTS in both groups were followed at 4-month intervals with the routine follow-up program of our department.


RESULTS
No significant difference was observed between the patients' characteristics of two groups. Compliance of the regimen in each group was 79% in CB Group and 85% in IC Group. No treatment-related death was observed. Five-year survival rates of CB Group and IC Group were 49% and 51%, and 5-year disease-free survival rates were 46% and 44%, respectively. There were no statistical differences between the two groups. Furthermore, no survival differences could be found between CB Group and IC Group in any subgroup of patients.


CONCLUSIONS
Both of these regimens were feasible. However, we have not observed any survival benefit in the CB Group in any subgroup, so far. Induction therapy, new chemotherapeutic agents, or anti-angiogenetic a agents may improve the survival of surgically treated lung cancer patients.
Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
M
M
Sagawa
M
M
Sato
S
S
Fujimura
K
K
Usuda
T
T
Kondo
T
T
Tanita
S
S
Takahashi
S
S
Ono
Y
Y
Matsumura
M
M
Handa
Y
Y
Saito
D000230:Adenocarcinoma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018287:Carcinoma, Large Cell / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D002945:Cisplatin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010844:Picibanil / Q000627:therapeutic use*; D011013:Pneumonectomy; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate; D005641:Tegafur / Q000627:therapeutic use*
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D005641:Tegafur; D010844:Picibanil; D002945:Cisplatin