title: Multimodality treatment and long-term follow-up of the primary pulmonary lymphoepithelioma-like carcinoma.
abstract: BACKGROUND
  Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a very rare subtype of non-small-cell lung cancer. Most cases are reported in Southeast Asia and are associated with Epstein-Barr virus infections. Because of its rare incidence, the optimal treatment and the results of long-term follow-up are not well understood. This study is an attempt to discover the multimodality treatment results of the primary pulmonary LELC.
  
  
  METHODS
  This retrospective study enrolled 21 patients with primary pulmonary LELC treated at 2 hospitals with a multimodality approach, including surgery, chemotherapy, radiotherapy, and targeted therapy.
  
  
  RESULTS
  The median follow-up time is 5.9 years and the median survival is 6.4 years. The median overall survival for patients with stage III and with stage IV disease is 3.4 years. In early-stage primary pulmonary LELC, surgery and adjuvant chemotherapy provided good treatment outcome. Advanced primary pulmonary LELC is relatively more chemosensitive and radiosensitive.
  
  
  CONCLUSIONS
  Patients with primary pulmonary LELC showed better prognosis than those with other types of non-small-cell lung cancer and achieved longer survival under multimodality treatment. This disease character is similar to that of nasopharyngeal carcinoma. Accurate pathologic diagnosis is recommended before the treatment. For advanced diseases, platinum-based doublet chemotherapy can be considered the first-line treatment. Radiation dose should consider tumor location, and 5000 to 7000 cGy is frequently applied for pulmonary LELC.
authors.affiliation: Division of Pulmonary Medicine and Intensive Care Medicine, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan. huang600517@yahoo.com
authors.forename: Chung-Jen
authors.initials: CJ
authors.lastname: Huang
authors.forename: An-Chen
authors.initials: AC
authors.lastname: Feng
authors.forename: Yueh-Fu
authors.initials: YF
authors.lastname: Fang
authors.forename: Wen-Hui
authors.initials: WH
authors.lastname: Ku
authors.forename: Nei-Min
authors.initials: NM
authors.lastname: Chu
authors.forename: Chih-Teng
authors.initials: CT
authors.lastname: Yu
authors.forename: Chia-Chuan
authors.initials: CC
authors.lastname: Liu
authors.forename: Ming-Yuan
authors.initials: MY
authors.lastname: Lee
authors.forename: Li-Han
authors.initials: LH
authors.lastname: Hsu
authors.forename: Stella Y C
authors.initials: SY
authors.lastname: Tsai
authors.forename: Chih-Shiun
authors.initials: CS
authors.lastname: Shih
authors.forename: Chih-Liang
authors.initials: CL
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000628:therapy* / Q000821:virology*; D003131:Combined Modality Therapy; D004279:DNA, Viral / Q000235:genetics; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000401:mortality / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D004854:Herpesvirus 4, Human / Q000235:genetics; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D004279:DNA, Viral