[Surgical morbidity for bronchial cancers after neoadjuvant treatment].
Two randomized trials, in 1994, have demonstrated the benefit of neoadjuvant chemotherapy, in term of median survival, for stage III lung cancer. Further studies have evaluated the potential benefit of chemotherapy or chemotherapy-radiotherapy association, either for patients suitable for surgery, or for non resectables tumors. However, these treatments treatments may increase the morbidity of surgery. Such an increase has not been demonstrated, except in one study, after chemotherapy alone before surgery. When radiation therapy is associated with pre-operative chemotherapy, the risk of complications seems to be dose dependent: low for doses below 50 Gy, important for doses over 55 Gy. These datas justify pre-operative lung function measurements and modifications of the surgical technic, especially for the lymphadenectomy extension. Despite this potential increase of morbidity, the benefit of neoadjuvant treatment is real.
Bonnette
P
P
Service de chirurgie thoracique, hôpital Foch, 40, rue Worth, 92151 Suresnes, France. p.bonnette@hopital-foch.fr
D000970:Antineoplastic Agents / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D003131:Combined Modality Therapy; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D008197:Lymph Node Excision / Q000009:adverse effects; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D010178:Pancoast Syndrome / Q000209:etiology / Q000517:prevention & control; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic; D012129:Respiratory Function Tests; D012306:Risk; D016896:Treatment Outcome
D000970:Antineoplastic Agents