Induction chemotherapy with mitomycin, vindesine, and cisplatin for stage IIIA (T1-3, N2) unresectable non-small-cell lung cancer: final results of the Toronto phase II trial.
OBJECTIVE
This is a phase II study to assess the role of induction chemotherapy in the management of stage IIIA non-small-cell lung cancer (NSCLC). We are now reporting the long-term follow-up of the Toronto phase II trial.


METHODS
Sixty five patients with mediastinoscopy proven stage IIIA NSCLC received two cycles of preoperative MVP or VLB/P followed by thoracotomy followed by two further courses of chemotherapy.


RESULTS
The overall response rate was 67.7% with three complete and 41 partial responders. Forty seven patients went on to thoracotomy with 35 complete resections. Pathologically 4.6% of patients had no tumour remaining. There were three postop deaths as well as five chemotherapy related deaths. Of the 35 patients completely resected 19 have recurred including eight in brain. The median survival for the entire 65 patients is 18.6 months with a 1 year survival of 66%, 5 year survival of 29% and a 10 year survival of 22%.


CONCLUSIONS
The long-term survival of induction chemotherapy is maintained. The high incidence of brain recurrences warrants assessment of the role of prophylactic cranial radiation. The role of surgery for stage IIIA NSCLC following induction chemotherapy awaits further study.
Burkes
Ronald L
RL
Mount Sinai Hospital, University of Toronto, 600 University Avenue, Suite 1221, Toronto, Ontario, Canada M5G 1X5. rburkes@mtsinai.on.ca
Shepherd
Frances A
FA
Blackstein
Martin E
ME
Goldberg
Melvin E
ME
Waters
Paul F
PF
Patterson
G Alexander
GA
Todd
Thomas
T
Pearson
F Griffith
FG
Jones
Donald
D
Farooq
Samina
S
McGlaughlin
John
J
Ginsberg
Robert J
RJ
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D016019:Survival Analysis; D013908:Thoracotomy; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage; D014751:Vindesine / Q000008:administration & dosage
D014747:Vinblastine; D002945:Cisplatin; D014751:Vindesine