Adjuvant or neoadjuvant chemotherapy in minimal N2 stage IIIA nonsmall cell lung cancer.
OBJECTIVE
In the last decade, numerous randomized trials have evaluated the benefit of (neo-)adjuvant chemotherapy in nonsmall cell lung cancer. This article will review the recent data on perioperative chemotherapy in stage III A-N2 nonsmall cell lung cancer and future research opportunities are presented.


RESULTS
Four retrospective series, two phase 2 and four phase 3 trials in the neoadjuvant setting and one retrospective series, two phase 2 trials and two phase 3 trials in the adjuvant setting are retrieved and discussed.


CONCLUSIONS
The available evidence does not allow to change the current recommendation regarding the management of patients presenting with biopsy-proven clinical stage IIIA-N2 nonsmall cell lung cancer: their preferred treatment is chemoradiotherapy. Surgery with neoadjuvant or adjuvant chemotherapy is not proven superior to radiotherapy. The patient occasionally presenting with unforeseen pN2 despite adequate preoperative mediastinal staging should be offered adjuvant cisplatin-based chemotherapy and possibly postoperative radiotherapy.
De Craene
Sofie
S
Department of Respiratory Medicine and Thoracic Oncology, University Hospital Ghent, Belgium.
Surmont
Veerle
V
van Meerbeeck
Jan P
JP
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011878:Radiotherapy
D000970:Antineoplastic Agents