Pathological response and prognosis of stage III non-small cell lung cancer patients treated with induction chemoradiation.
OBJECTIVE
The aim of this study was to clarify the relationship between pathological effects and the prognosis of patients with stage III non-small cell lung cancer (NSCLC) treated with induction chemoradiation.


METHODS
Patients who were untreated and potentially resectable with stage III NSCLC were enrolled. They received carboplatin and docetaxel with concurrent radiotherapy (5 × 2 Gy/week with a total dose of 40 Gy) followed by surgery. We assessed the relationship between the pathological effect (Ef) (Ef 1: slight pathological response, Ef 2: moderate pathological response, Ef 3: complete pathological response) and prognosis.


RESULTS
In all, 30 patients with stage III NSCLC (24 men and 6 women, mean age 60.7 years, 17 with adenocarcinomas and 13 with squamous cell carcinomas, 21 with clinical stage IIIA and nine with stage IIIB) participated in the trial and underwent induction chemoradiation. A total of 27 patients (90%) with complete response, partial response and stable disease had surgical resection. The pathological effect was Ef 1 and Ef 2 in 10 patients each, and Ef 3 in seven patients. Median survival was 10.9 months in patients with Ef 1 and 49.6 months in patients with Ef 2. Six out of seven Ef 3 patients are alive at the time of writing with a mean survival of 77.1 months (14-104 months). There was a significant difference in overall survival based on pathological effect rating (P = 0.0036).


CONCLUSIONS
The Ef rating was well correlated with prognosis after induction chemoradiation.
Department of Respiratory Medicine, Toho University Omori Medical Center, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, Japan. kazutoshiisobe@aol.com
Kazutoshi
K
Isobe
Yoshinobu
Y
Hata
Shinji
S
Sakaguchi
Fumitomo
F
Sato
Shoji
S
Takahashi
Keita
K
Sato
Go
G
Sano
Keishi
K
Sugino
Susumu
S
Sakamoto
Yujiro
Y
Takai
Aki
A
Mitsuda
Atsuro
A
Terahara
Kazutoshi
K
Shibuya
Keigo
K
Takagi
Sakae
S
Homma
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods; D000077143:Docetaxel; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage
D043823:Taxoids; D000077143:Docetaxel; D016190:Carboplatin