[Preoperative induction chemotherapy for unresectable stage IIIA non-small-cell lung cancer].
OBJECTIVE
To evaluate the potential reconsideration of curative operative treatment for patients with unresectable stage IIIA (N2) non-small-cell lung cancer (NSCLC).


METHODS
From Jan. 1999 to Dec. 2002, 76 patients with unresectable stage IIIA (N2) NSCLC were entered in this study. They had all been proved by chest CT, chest film and fiberobronchoscopy. Twenty-one (27.6%) patients were examined by mediastinoscopy. All the patients received two cycles of chemotherapy with NVB (25 mg/m(2), D1, D5) and carboplatin (300 mg/m(2), D1). All the patients were staged again three weeks after induction chemotherapy. Sixty-four patients who achieved partial response (PR) or complete response (CR) were allowed to undergo surgery. Twelve patients who did not responde to chemotherapy received radiotherapy instead. Of the 64 surgically treated patients, 56 (84.7%) had a complete resection and then received 2 cycles of chemotherapy using the same regime, 8 patients had an incomplete resection and then received radiotherapy for the residual tumor.


RESULTS
The median survival for these 76 patients with unresectable stage IIIA (N2) NSCLC treated by either surgery or radiation after induction chemotherapy was 18.6 months with 1-, 2-, 3-year survival rate of 64.2%, 39.4% and 25.6%, respectively. The median survival for the 56 patients with a complete resection was 28.2 months with 1-, 2-, 3-year survival rate of 70.4%, 52.5% and 38.6%, respectively.


CONCLUSIONS
Preoperative induction chemotherapy with NVB plus carboplatin should be seriously considered for the patients with unresectable stage IIIA (N2) NSCLC, It is suggested that, whenever possible, surgery should be taken as the first choice for the patients who show down-staged benefits that complete resection can be attempted.
Department of Thoracic Surgical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, China.
Si-yu
SY
Wang
Zhi-fan
ZF
Zeng
Wei
W
Ou
Yong-bin
YB
Lin
Tie-hua
TH
Rong
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008481:Mediastinoscopy; D008875:Middle Aged; D011300:Preoperative Care; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
D014747:Vinblastine; D016190:Carboplatin; D000077235:Vinorelbine