title: Induction concurrent chemoradiation therapy for invading apical non-small cell lung cancer.
abstract: OBJECTIVE
  Although non-small cell lung cancer (NSCLC) involving the superior sulcus has been generally treated with radiation therapy (RT) followed by surgery, local recurrence is still a big problem to be solved. We investigated a role of induction therapy, especially induction concurrent chemoradiation therapy (CRT), on the surgical results of this type of NSCLC.
  
  
  METHODS
  We retrospectively reviewed 30 patients with NSCLC invading the apex of the chest wall who underwent surgery from 1987 to 1996. Ten patients (57 +/- 8 years) received surgery alone, 9 (55 +/- 13 years) received RT (42 +/- 7 Gy) followed by surgery and 11 (51 +/- 9 years) received cisplatin based chemotherapy and RT (47 +/- 5 Gy) as an induction therapy.
  
  
  RESULTS
  Two and 4-year survival rates were 30% and 20% in patients with surgery alone, 22% and 11% in patients with induction RT, and 73% and 53% in patients with induction CRT, respectively. The survival was significantly better in patients with induction CRT than those with induction RT or surgery alone. Univariate analysis demonstrated that curability (yes versus no: p = 0.027) and induction therapy (surgery alone and RT versus CRT: p = 0.0173) were significant prognostic factors. Multivariate analysis revealed that only induction therapy (p = 0.0238) was a significant prognostic factor.
  
  
  CONCLUSIONS
  Induction CRT seems to improve the survival in patients with NSCLC invading the apex of the chest wall compared with induction RT or surgery alone.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery (E1), Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyoshi
authors.forename: Keiji
authors.initials: K
authors.lastname: Iuchi
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakamura
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Hajime
authors.initials: H
authors.lastname: Maeda
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ohno
authors.forename: Kazuya
authors.initials: K
authors.lastname: Nakahara
authors.forename: Noboru
authors.initials: N
authors.lastname: Nakano
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Ohta
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome