Postoperative complications after induction chemoradiotherapy in patients with non-small-cell lung cancer.
OBJECTIVE
This study evaluates the risks of postoperative complications in 124 patients with non-small-cell lung cancer who received pre-operative induction chemoradiotherapy and surgery.


METHODS
All patients with non-small-cell lung cancer who underwent surgery after induction therapy between January 1990 and December 2003 were reviewed. We adopted univariate and multiple logistic regression models to identify predictors that increased the incidence of postoperative complications.


RESULTS
Of 124 patients, 59 received carboplatin and docetaxel, 53 received cisplatin and etoposide, and 12 received other platinum-based combinations. Pre-operative thoracic radiotherapy was performed concurrently with chemotherapy. The median dose to the primary tumor was 40 Gy, and 29 patients (23.4%) received radiotherapy of more than 45 Gy before surgery. There were 25 pneumonectomies (20.2%). The overall postoperative mortality was 9 of 124 patients (7.3%), and complications developed in 54 patients (43.5%). Multivariate analysis demonstrated that only thoracic radiotherapy of more than 45 Gy predicted postoperative complications (P = 0.021; odds ratio, 3.620; 95% confidence interval, 1.214-10.797).


CONCLUSIONS
Thoracic radiotherapy of more than 45 Gy, in combination with chemotherapy, was a significant risk factor for postoperative complications.
Fujita
Shiro
S
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Syogoin Kawaracho, Kyoto 606-8507, Japan. sfujita@kuhp.kyoto-uac.jp
Katakami
Nobuyuki
N
Takahashi
Yutaka
Y
Hirokawa
Keiko
K
Ikeda
Akihiko
A
Tabata
Chiharu
C
Mio
Tadashi
T
Mishima
Michiaki
M