title: What outcome after the prescription of neoadjuvant chemotherapy in lung cancer?
abstract: BACKGROUND
  The treatment of patients with locally advanced non-small-cell lung cancer is controversial. Surgery remains the gold standard, even in this group. Neoadjuvant chemotherapy could allow surgical resection in patients initially judged inoperable.
  
  
  METHODS
  From January 2009 to May 2010, neoadjuvant chemotherapy was indicated in 27 patients with NSCLC (25 men, 2 women). Their mean age was 65 years. The stages were: IIB in 5, IIIA in 17 (6 in stage IIIAN2), IIIB in 2, and IV in 3.
  
  
  RESULTS
  23 patients received neoadjuvant chemotherapy, 2 refused induction treatment, and 2 had impaired status. The neoadjuvant chemotherapy regimen was gemcitabine-cisplatin in 17 patients and vinorelbine-cisplatin in 6. Only 5 patients underwent complete surgical treatment after induction: 1 in stage IIB, 1 in stage IIIAN0, 1 in IIIB, and 2 in stage IV (1 operated brain metastasis, and 1 operated adrenal metastasis). Surgical treatment was not achieved after neoadjuvant chemotherapy in 18 patients because of progressive disease.
  
  
  CONCLUSIONS
  Neoadjuvant chemotherapy offers several potential benefits, but it may delay surgery or eliminate eligibility as a surgical candidate. Rigorous patient selection for this type of multimodal treatment is essential.
authors.affiliation: Department of Cardiothoracic Surgery, Abderrahmen Mami University Hospital, Ariana, Tunisia.
authors.forename: Mohamed-Sadok
authors.initials: MS
authors.lastname: Boudaya
authors.forename: Hanène
authors.initials: H
authors.lastname: Smadhi
authors.forename: Adel
authors.initials: A
authors.lastname: Marghli
authors.forename: Fatma
authors.initials: F
authors.lastname: Charmiti
authors.forename: Sonia
authors.initials: S
authors.lastname: Ouerghi
authors.forename: Jalel
authors.initials: J
authors.lastname: Mohamed
authors.forename: Emna
authors.initials: E
authors.lastname: Brahem
authors.forename: Belhassen
authors.initials: B
authors.lastname: Smati
authors.forename: Taher
authors.initials: T
authors.lastname: Mestiri
authors.forename: Tarek
authors.initials: T
authors.lastname: Kilani
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018450:Disease Progression; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018579:Patient Selection; D011013:Pneumonectomy; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D014747:Vinblastine; D002945:Cisplatin; D000077235:Vinorelbine; D000093542:Gemcitabine
keywords: Antineoplastic combined chemotherapy protocols; adjuvant; carcinoma; chemotherapy; lung neoplasms; neoadjuvant therapy; non-small-cell lung