Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Weiden, P. L.
Right arrow Articles by Piantadosi, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Weiden, P. L.
Right arrow Articles by Piantadosi, S.
(Chest. 1994;106:344S-347S.)
© 1994 American College of Chest Physicians

Preoperative Chemotherapy (Cisplatin and Fluorouracil) and Radiation Therapy in Stage III Non-small Cell Lung Cancer

A Phase 2 Study of the LCSG

Paul L. Weiden MD1 and Steve Piantadosi MD, PhD2

1 From the Virginia Mason Medical Center Seattle
2 From the Johns Hopkins Oncology Center, Baltimore

Study objective: To determine the feasibility, toxicity, and potential efficacy of neoadjuvant chemoradiotherapy before surgery in patients with non-small cell lung cancer limited to the chest.

Design: Phase 2 pilot study.

Setting: Multi-institutional, multimodality cooperative group.

Patients: Eight-five patients with advanced stage III-A or minimal stage III-B non-small cell lung cancer in whom attempted resection would have been likely to leave residual disease.

Intervention: Cisplatin, 75 mg/m2, was given on days 1 and 29; fluorouracil, 1 g/m2 for 24 h, was given as a continuous infusion on days 1 to 4 and 29 to 32; thoracic radiation, 30 Gy in 15 fractions, was administered on days 1 to 19. Thoracotomy with tumor resection was planned for day 57.

Measurements and results: Two patients achieved a complete and 46 achieved a partial response after the neoadjuvant chemoradiotherapy for an overall response rate of 56%. Toxicity was moderate but acceptable. Fifty-four patients underwent thoracotomy and tumor resection was attempted in 44; 29 (34%) had complete and 15 (18%) had incomplete resections. There was no apparent increase in postoperative complications. In eight patients (9%), no viable tumor was detected pathologically in the resection specimen. Of the 18 patients whose tumors were completely resected and had disease recurrence, none had recurrence only in the chest, 15 (83%) had recurrence in distal sites, and 3 (17%) developed second primary tumors. Median survival of all patients was 13 months.

Conclusions: This neoadjuvant regimen did not appear to provide major benefit in patients with advanced but potentially resectable non-small cell lung cancer. Further studies are needed to better define the relative roles of preoperative radiotherapy and chemotherapy.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1994 by the American College of Chest Physicians.