Chemotherapy and high dose radiotherapy followed by resection for locally advanced nonsmall cell lung cancers.


Journal Article

OBJECTIVES: For locally advanced but technically operable nonsmall cell lung cancer (NSCLC), neoadjuvant chemoradiotherapy is frequently used. Ideal radiotherapy dose in this context is unclear. MATERIALS AND METHODS: Twenty-six NSCLC patients with N2 disease were retrospectively reviewed. All received preoperative concurrent platinum-based chemoradiotherapy. Gross tumor volumes received a median of 58 Gy (range, 50-60 Gy). RESULTS: Two patients experienced major complications and died, resulting in a postoperative mortality rate of 7.7%. Three patients (11.5%) had minor complications. Pathologic specimens revealed downstaging in 76.9% of patients. The pathologic complete response (CR) rate was 34.6%. Downstaging of nodes was observed in 20 of 26 patients. With a median follow-up of 18.3 months, the 1- and 3-year actuarial survival rates were 80.2% and 45.7%, respectively. The 1- and 3-year actuarial disease-free survival (DFS) rates were 76.9% and 37.3%, respectively. Patients experiencing mediastinal downstaging had better DFS rates, relative to patients that did not (18-month DFS = 79.2% vs. 0%; P = 0.0001). Differences in RT dose (50-60 Gy) and types of chemotherapeutic regimens did not significantly impact pathologic downstaging rates, CR rates, DFS, or survival. DISCUSSION: Neoadjuvant chemotherapy with high-dose concurrent RT is well tolerated and results in favorable outcomes.

Full Text

Duke Authors

Cited Authors

  • Shaikh, AY; Haraf, DJ; Salama, JK; Salgia, R; Hoffman, PC; Ferguson, MK; Connell, PP

Published Date

  • June 2007

Published In

Volume / Issue

  • 30 / 3

Start / End Page

  • 258 - 263

PubMed ID

  • 17551302

Pubmed Central ID

  • 17551302

Electronic International Standard Serial Number (EISSN)

  • 1537-453X

Digital Object Identifier (DOI)

  • 10.1097/01.coc.0000258109.83083.78


  • eng

Conference Location

  • United States