title: 10-year long-term survival (LTS) of induction chemotherapy with three cycles cisplatin/paclitaxel followed by concurrent chemoradiation cisplatin/etoposide/45 Gy (1.5 Gy bid) plus surgery in locally advanced non-small-cell lung cancer (NSCLC)-a multicenter phase-II trial (CISTAXOL).
abstract: BACKGROUND
  Induction chemoradiotherapy plus surgery remains an option to study in IIIA(N2) and selected IIIB NSCLC. Here we report ten-year long-term survival of a prospective multicenter German-French phase-II trial with trimodality.
  
  
  METHODS
  Mediastinoscopically proven IIIA(N2)/selected IIIB NSCLC received three cycles cisplatin (50 mg/m(2) day 1+8) and paclitaxel (175 mg/m(2)d1) qd 22. Concurrent CTx/RTx followed: 45 Gy (1.5 Gy bid) with cisplatin 50 mg/m(2) day 2+9 and etoposide 100 mg/m(2) d 4-6. Surgery was planned three to five weeks after RTx. If evaluated inoperable/irresectable at the end of RTx, definitive RTx-boost (20 Gy; 2 Gy qd) followed. Here we report 10-year-LTS for this cohort.
  
  
  RESULTS
  All 64 patients were accrued 3/99 to 2/02. Patients characteristics: IIIA(N2)/IIIB 25/39; m/f 48/16; adeno/squamous/large-cell/adenosquamous/NOS 15/26/18/3/2; age: median 52.5 (range 33-69). 36 operated: R0 32/36 (89%); pCR 16/36 (44%). 10-year-LTS%; all 26.0; IIIA(N2) 37.1; IIIB 17.9; relevant prognostic factors (exploratory): pretreatment - histopathology (squamous/adeno) - age (<50/≥50) - Charlson-CI: 1/>1 - BMI (≥25/<25) - pack years smoking (≥10/<10); treatment-dependent - R0/no-R0.
  
  
  CONCLUSIONS
  This regimen achieves substantial LTS. Interestingly, adenocarcinomas, older patients, unfavorable comorbidity scores, higher BMI and light smokers demonstrate poor long-term outcome even with aggressive trimodality. This dataset defines the rationale for our ongoing randomized trial with surgery after induction therapy in IIIA(N2)/selected IIIB (ESPATÜ).
authors: West German Cancer Centre, Department of Medical Oncology, 45122 Essen, Germany. Electronic address: wilfried.eberhardt@uni-essen.de.
authors: Wilfried Ernst Erich
authors: WE
authors: Eberhardt
authors: Thomas Christoph
authors: TC
authors: Gauler
authors: Cecile
authors: C
authors: Lepechoux
authors: Georgios
authors: G
authors: Stamatis
authors: Stephan
authors: S
authors: Bildat
authors: Thomas
authors: T
authors: Krbek
authors: Stefan
authors: S
authors: Welter
authors: Dominique
authors: D
authors: Grunenwald
authors: Berthold
authors: B
authors: Fischer
authors: Hepp de Los Rios
authors: Hde L
authors: Rodrigo
authors: Dirk
authors: D
authors: Theegarten
authors: Thierry
authors: T
authors: Le Chevalier
authors: Siegfried
authors: S
authors: Seeber
authors: Martin
authors: M
authors: Stuschke
authors: Christoph
authors: C
authors: Poettgen
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000628:therapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D060828:Induction Chemotherapy; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D011446:Prospective Studies; D017741:Survivors; D016896:Treatment Outcome
chemical_list: D005047:Etoposide; D017239:Paclitaxel; D002945:Cisplatin
keywords: 10-Year survival; Induction chemoradiotherapy; Lung cancer; Prognostic factors; Surgery; Trimodality treatment