[Early stages of non small cell lung cancer (I. II. IIIA). Role of preoperative treatments].
The first meta-analysis of preoperative chemotherapy in non-small cell lung cancer (NSCLC) was published by Berghmans et coll. It included the first six reported studies and, despite the small number of patients involved, concluded in favour of preoperative chemotherapy. These six trials are summarized here. There are three other trials, which were not included in this meta-analysis; the SWOG study which was presented at the ASCO meeting in 2005 and an Italian and a Spanish trial, the results of which are still awaited. The advantages of preoperative chemotherapy are discussed. There are two other trials, whose designs are very different. The objective of the study by Albain et coll. was to evaluate the role of surgery after induction chemo-radiation in stage IIIa NSCLC. The results seem to be encouraging in patients who can undergo a (bi)lobectomy. The objective of the second trial was to evaluate whether surgery could improve survival after chemotherapy compared to thoracic irradiation in unresectable stage III disease. Although chemotherapy probably increased resectability, survival was not improved in operated patients.
Depierre
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CHU de Besançon, Université de Franche-Comté, Besançon, France. pneumo-depierre@ufc-chu.univ-fcomte.fr
D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D009367:Neoplasm Staging; D011300:Preoperative Care