Prospective study of adjuvant chemotherapy for pulmonary large cell neuroendocrine carcinoma.
BACKGROUND
Patients with pulmonary large cell neuroendocrine carcinoma (LCNEC) have a very poor prognosis, but the benefit of adjuvant chemotherapy for these patients has not been established. We performed a prospective analysis of adjuvant chemotherapy for patients with completely resected pulmonary LCNECs to assess the effect of adjuvant chemotherapy.


METHODS
The adjuvant mixture consisted of cisplatin and VP-16 and was administered after surgery to 15 patients with LCNECs from 2000 to 2005. We compared patient survival with historical data for LCNEC patients treated without platinum-based adjuvant chemotherapy after surgery.


RESULTS
There were no differences in age, gender, surgical methods, and staging between the adjuvant chemotherapy group and the control group. Median follow-up was 33 months for the adjuvant group and 42 months for the control group. Of the 15 patients in the adjuvant chemotherapy group, 2 patients had disease recurrence and 1 died of interstitial pneumonia. The overall survival rate at 2 and 5 years of patients with adjuvant chemotherapy was 88.9%. The overall survival rate between patients with adjuvant chemotherapy and the historical control group was significantly different.


CONCLUSIONS
Adjuvant chemotherapy consisting of cisplatin and VP-16 after surgery appears promising for the improvement of the prognosis for patients with completely resected LCNECs, and it should be evaluated further in larger multi-institutional trials.
Iyoda
Akira
A
Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Hiroshima
Kenzo
K
Moriya
Yasumitsu
Y
Takiguchi
Yuichi
Y
Sekine
Yasuo
Y
Shibuya
Kiyoshi
K
Iizasa
Toshihiko
T
Kimura
Hideki
H
Nakatani
Yukio
Y
Fujisawa
Takehiko
T
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D005047:Etoposide; D002945:Cisplatin